Klinika Neurologii Śląskiego Uniwersytetu Medycznego w Katowicach, Zabrze, Polska.
Neurol Neurochir Pol. 2012 Nov-Dec;46(6):519-28. doi: 10.5114/ninp.2012.32278.
Early atherosclerotic changes in carotid arteries can be detected using ultrasound examination. The aim of this study was to assess correlations between intima-media thickness (IMT) and gender, age and clinical features of diabetes mellitus (DM).
The study group consisted of 73 patients with type 2 DM (mean age: 63.6 ± 7.5 years), and 74 controls without DM (mean age 62.2 ± 7.5 years). Analysed clinical features of diabetes included disease duration, anti-diabetic treatment, glycaemic control (HbA1c level), presence of metabolic syndrome, and complications of macro- and microangiopathy. IMT was measured using ultrasonography in the carotid arteries (common - CCA, bifurcation, internal - ICA) bilaterally.
Mean and maximum IMT in the CCA was greater in diabetic patients than in controls. Age and male sex, but not vascular risk factors, were independent predictors of increased IMT in all segments. Macroangiopathy correlated with IMT within both CCA in univariate analysis. After adjusting for age and gender, this relationship remained significant in the right CCA in middle-aged patients (59-67 years; p = 0.01 for mean IMT, p = 0.02 for maximum IMT). In patients without metabolic syndrome, IMT in the right CCA bifurcation correlated with HbA1c level (p = 0.05). Patients treated simultaneously with insulin and oral antidiabetic drugs had smaller IMT in the right ICA than those treated with insulin only (0.471 ± 0.105 vs. 0.678 ± 0.209 mm; p = 0.04).
In diabetic patients, ultrasound IMT measurement can be used to assess the cardiovascular risk and to determine indications for intensified anti-diabetic treatment. IMT is a sensitive marker of early carotid atherosclerosis, particularly on the right side.
通过超声检查可以检测到颈动脉的早期动脉粥样硬化变化。本研究旨在评估颈动脉内膜中层厚度（IMT）与性别、年龄和糖尿病临床特征之间的相关性。
研究组由 73 例 2 型糖尿病患者（平均年龄：63.6 ± 7.5 岁）和 74 例无糖尿病对照者（平均年龄 62.2 ± 7.5 岁）组成。分析的糖尿病临床特征包括疾病持续时间、抗糖尿病治疗、血糖控制（HbA1c 水平）、代谢综合征的存在以及大血管和微血管并发症。使用超声在双侧颈动脉（颈总动脉 - CCA、分叉处、颈内动脉 - ICA）测量 IMT。
与对照组相比，糖尿病患者的 CCA 平均和最大 IMT 更大。年龄和男性性别，但不是血管危险因素，是所有节段 IMT 增加的独立预测因素。在单变量分析中，大血管疾病与 CCA 各段的 IMT 相关。在校正年龄和性别后，这种关系在中年患者（59-67 岁；CCA 平均 IMT 时为 p = 0.01，最大 IMT 时为 p = 0.02）右侧仍具有显著性。在无代谢综合征的患者中，右侧 CCA 分叉处的 IMT 与 HbA1c 水平相关（p = 0.05）。同时接受胰岛素和口服降糖药物治疗的患者右侧颈内动脉 IMT 小于仅接受胰岛素治疗的患者（0.471 ± 0.105 对 0.678 ± 0.209 mm；p = 0.04）。
在糖尿病患者中，超声 IMT 测量可用于评估心血管风险，并确定强化抗糖尿病治疗的指征。IMT 是早期颈动脉粥样硬化的敏感标志物，特别是在右侧。
