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颈动脉内中膜厚度进展的危险因素:新诊断 2 型糖尿病患者的 2 年随访研究。

Risk factors for the progression of intima-media thickness of carotid arteries: a 2-year follow-up study in patients with newly diagnosed type 2 diabetes.

机构信息

Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.

出版信息

Diabetes Metab J. 2013 Oct;37(5):365-74. doi: 10.4093/dmj.2013.37.5.365. Epub 2013 Oct 17.

DOI:10.4093/dmj.2013.37.5.365
PMID:24199166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3816138/
Abstract

BACKGROUND

Intima-media thickness (IMT) of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM).

METHODS

Patients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared.

RESULTS

Of the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C) levels in males and high density lipoprotein cholesterol (HDL-C) levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS) 10-year coronary heart disease (CHD) risk score after 2 years was generally higher in the nonprogression group than the progression group.

CONCLUSION

LDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.

摘要

背景

颈动脉内-中膜厚度(IMT)与心血管疾病的风险呈正相关。本研究旨在确定影响 2 型糖尿病(T2DM)患者颈动脉 IMT 进展的危险因素。

方法

本研究纳入了新诊断为 T2DM 且有颈动脉 IMT 测量值的患者,并比较了他们在基线和 2 年后的临床数据和颈动脉 IMT 结果。

结果

在 171 名患者中,67.2%的男性和 50.8%的女性左颈总动脉的基线 IMT 异常。在基线时,男性中收缩压、体重指数和吸烟,以及女性中空腹血糖和糖化血红蛋白水平在 IMT 异常的患者中明显高于 IMT 正常的患者。在 2 年随访时,男性中的低密度脂蛋白胆固醇(LDL-C)水平和女性中的高密度脂蛋白胆固醇(HDL-C)水平在非进展组和进展组之间存在显著差异。在 2 年时,英国前瞻性糖尿病研究(UKPDS)10 年冠心病(CHD)风险评分的降低在非进展组中普遍高于进展组。

结论

在颈动脉 IMT 无进展和进展组之间,在 2 年随访时,男性中的 LDL-C 水平和女性中的 HDL-C 水平存在显著差异。此外,UKPDS 10 年 CHD 风险评分的降低似乎延缓了动脉粥样硬化的进展。因此,强调为新诊断的 T2DM 患者建立血脂谱治疗目标的重要性,以预防颈动脉 IMT 的进展。

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Maximum carotid intima-media thickness improves the prediction ability of coronary artery stenosis in type 2 diabetic patients without history of coronary artery disease.颈动脉内膜中层厚度最大值可提高无冠心病史 2 型糖尿病患者的冠状动脉狭窄预测能力。
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