Wakabayashi Ichiro, Masuda Hiroshi
Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan.
Blood Press. 2007;16(1):56-62. doi: 10.1080/08037050701248051.
Pulse pressure is known to be a potent risk factor for cardiovascular disease. However, it has not been determined whether pulse pressure is associated with cerebrovascular disease in patients with diabetes mellitus. The purpose of the present study was to investigate association of pulse pressure with carotid atherosclerosis in patients with diabetes and to determine whether age and gender affect the association. A cross-sectional study was performed using outpatients with type 2 diabetes. Carotid atherosclerosis and arterial stiffness were evaluated by intima-media thickness of common carotid arteries (IMT) and aortic pulse wave velocity (a-PWV), respectively. The relationship of brachial pulse pressure with IMT was analyzed. Pulse pressure was significantly correlated with age, duration of diabetes, systolic blood pressure, serum sialic acid, a-PWV and IMT. The mean IMT in the highest tertile group of pulse pressure after adjustment for gender was significantly higher than the mean IMT in the lowest tertile group. In analysis using subgroups of gender, a significant correlation between pulse pressure and IMT was shown in women but not in men. In multiple regression analysis, there was a significant correlation between pulse pressure and IMT in women independently of age, body mass index, systolic blood pressure, hemoglobin A1c, atherogenic index, a-PWV, history of therapy for hypertension and history of nephropathy. The results of this study suggest that pulse pressure is a major age-independent predictor of carotid atherosclerosis in female patients with diabetes.
脉压是已知的心血管疾病的一个重要危险因素。然而，糖尿病患者的脉压与脑血管疾病之间是否存在关联尚未确定。本研究的目的是调查糖尿病患者脉压与颈动脉粥样硬化的关联，并确定年龄和性别是否会影响这种关联。我们对2型糖尿病门诊患者进行了一项横断面研究。分别通过颈总动脉内膜中层厚度（IMT）和主动脉脉搏波速度（a-PWV）评估颈动脉粥样硬化和动脉僵硬度。分析了肱动脉脉压与IMT之间的关系。脉压与年龄、糖尿病病程、收缩压、血清唾液酸、a-PWV和IMT显著相关。在对性别进行校正后，脉压最高三分位数组的平均IMT显著高于最低三分位数组。在按性别分组的分析中，脉压与IMT之间在女性中显示出显著相关性，而在男性中未显示出显著相关性。在多元回归分析中，女性的脉压与IMT之间存在显著相关性，且独立于年龄、体重指数、收缩压、糖化血红蛋白、致动脉粥样硬化指数、a-PWV、高血压治疗史和肾病病史。本研究结果表明，脉压是女性糖尿病患者颈动脉粥样硬化的一个主要的与年龄无关的预测因素。
