Department of Rehabilitation Technology, TzuHui Institute of Technology, Pingtung, Taiwan.
J Endocrinol Invest. 2012 Mar;35(3):254-9. doi: 10.3275/7756. Epub 2011 May 27.
To examine the association of microalbuminuria (MAU) with the carotid intima-media thickness (CIMT) in Chinese Type 2 diabetic subjects.
Two hundred and thirty-nine patients (64±13 yr, 154 males) were divided into 2 groups: one with MAU (no.=119) or one without (no.=120). We recorded clinical and biochemical data as well as CIMT and ankle-brachial index (ABI).
The patients with MAU had had diabetes mellitus (DM) longer, had higher blood pressure (BP). They also had lower estimated glomerular filtration rate (eGFR) and higher levels of circulating glucose, glycated hemoglobin, high sensitivity C-reactive protein than those without. Lower mean ABI was found in those with MAU, however, they did not have higher mean CIMT (0.72±0.15 vs 0.71±0.16 mm, p=0.525). In patients without MAU, CIMT correlated with age, DM duration, systolic BP, eGFR, albumin- to-creatinine ratio, and ABI. However, in those with MAU, CIMT correlated only with age and eGFR. Multivariate regression analysis revealed that mean CIMT correlated only with age for patients without MAU, but correlated with age and body mass index for those with MAU. Dividing the patients into 5 age groups, we found that the older the patient, the higher the mean CIMT with no group differences between those with and without MAU in both genders. However, patients with eGFR below 60 ml/min/1.73 m(2) had higher mean CIMT than those above (0.75±0.16 vs 0.69±0.14 mm, p=0.005).
Type 2 diabetic patients with MAU were not associated with higher CIMT. Conversely, those with deterioration of renal function were more likely associated.
研究微量白蛋白尿(MAU)与中国 2 型糖尿病患者颈动脉内膜中层厚度(CIMT)的关系。
239 例患者(64±13 岁,154 例男性)分为 MAU 组(n=119)和非 MAU 组(n=120)。记录临床和生化数据以及 CIMT 和踝臂指数(ABI)。
MAU 组糖尿病病史更长,血压更高。他们的估算肾小球滤过率(eGFR)更低,循环血糖、糖化血红蛋白、高敏 C 反应蛋白水平更高。MAU 组平均 ABI 较低,但平均 CIMT 无差异(0.72±0.15 vs 0.71±0.16 mm,p=0.525)。在无 MAU 组,CIMT 与年龄、糖尿病病程、收缩压、eGFR、白蛋白与肌酐比值和 ABI 相关。然而,在 MAU 组,CIMT 仅与年龄和 eGFR 相关。多元回归分析显示,在无 MAU 组,平均 CIMT 仅与年龄相关,而在 MAU 组,平均 CIMT 与年龄和体重指数相关。将患者分为 5 个年龄组,我们发现年龄越大,CIMT 越高,无论有无 MAU,男性和女性各年龄组之间的 CIMT 无差异。然而,eGFR 低于 60 ml/min/1.73 m(2)的患者 CIMT 高于 eGFR 较高者(0.75±0.16 vs 0.69±0.14 mm,p=0.005)。
2 型糖尿病伴 MAU 患者 CIMT 不高。相反,肾功能恶化者更可能发生。