Sigurdardottir Vilborg, Fagerberg Björn, Hulthe Johannes
Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden.
Diabetes Care. 2004 Apr;27(4):880-4. doi: 10.2337/diacare.27.4.880.
The aim of this study was to investigate the occurrence of subclinical atherosclerosis and underlying mechanisms in men with newly diagnosed diabetes and established diabetes compared with healthy control subjects.
In a population-based study of 61-year-old Caucasian men (n = 271) with established diabetes (n = 50) and newly diagnosed diabetes (n = 24) and healthy control subjects (n = 197), standard risk factors and highly sensitive (hs) C-reactive protein (CRP) were measured. Ultrasound measurements of intima-media thickness (IMT) were performed bilaterally in the common carotid artery, and a composite measure was calculated from common carotid and carotid bulb IMT (composite IMT). The plaque status was assessed.
Composite IMT and carotid plaque size increased gradually among the healthy control subjects, newly diagnosed diabetic patients, and established diabetic patients (P for trend < or =0.001, respectively). CRP was higher in newly and established diabetes (NS between diabetes groups) compared with healthy control subjects (P < 0.001). Total cholesterol levels were lower in newly diagnosed diabetes (5.51 +/- 1.13 mmol/l, P < 0.05) and established diabetes (5.45 +/- 1.15 mmol/l, P < 0.01) compared with those of healthy control subjects (5.77 +/- 1.03 mmol/l). In men with diabetes (n = 74), diabetes onset status (newly diagnosed versus established), waist-to-hip ratio (WHR), and serum triglycerides, but not CRP, explained 16% of the variance in composite IMT.
This is the first study to show increased preclinical atherosclerotic changes (IMT and plaque size) and increased inflammation (hs-CRP) in men with newly diagnosed diabetes as well as in patients with established diabetes compared with healthy control subjects. WHR, diabetes onset status (newly diagnosed versus established), and triglycerides, but not CRP, were independent correlates of carotid artery IMT in men with diabetes.
本研究旨在调查新诊断糖尿病男性和已确诊糖尿病男性与健康对照者相比亚临床动脉粥样硬化的发生情况及其潜在机制。
在一项基于人群的研究中，对61岁的白种男性（n = 271）进行研究，其中已确诊糖尿病患者（n = 50）、新诊断糖尿病患者（n = 24）以及健康对照者（n = 197），测量其标准危险因素和高敏（hs）C反应蛋白（CRP）。双侧颈总动脉进行内膜中层厚度（IMT）的超声测量，并根据颈总动脉和颈动脉球部IMT计算复合测量值（复合IMT）。评估斑块状态。
在健康对照者、新诊断糖尿病患者和已确诊糖尿病患者中，复合IMT和颈动脉斑块大小逐渐增加（趋势P分别≤0.001）。与健康对照者相比，新诊断糖尿病和已确诊糖尿病患者的CRP更高（糖尿病组之间无显著差异）（P < 0.001）。与健康对照者（5.77±1.03 mmol/l）相比，新诊断糖尿病患者（5.51±1.13 mmol/l，P < 0.05）和已确诊糖尿病患者（5.45±1.15 mmol/l，P < 0.01）的总胆固醇水平较低。在糖尿病男性（n = 74）中，糖尿病发病状态（新诊断与已确诊）、腰臀比（WHR）和血清甘油三酯，但不包括CRP，解释了复合IMT中16%的变异。
这是第一项研究表明，与健康对照者相比，新诊断糖尿病男性以及已确诊糖尿病患者的临床前期动脉粥样硬化变化（IMT和斑块大小）增加以及炎症（hs-CRP）增加。WHR、糖尿病发病状态（新诊断与已确诊）和甘油三酯，而非CRP，是糖尿病男性颈动脉IMT的独立相关因素。
