Strang Aart C, van Wijk Diederik F, Mutsaerts Henri J M M, Stroes Erik S G, Nederveen Aart J, Rotmans Joris I, Rabelink Ton J, Box Frieke M A
Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Diab Vasc Dis Res. 2015 Mar;12(2):126-32. doi: 10.1177/1479164114559511. Epub 2015 Jan 14.
Efficacy of guideline cardiovascular disease prevention regimens may differ between patients with or without type II diabetes mellitus. We therefore compared change in carotid artery wall dimensions in type II diabetes mellitus and non-type II diabetes mellitus patients with a history of a major cardiovascular disease event, using magnetic resonance imaging.
Thirty type II diabetes mellitus patients and 29 age- and sex-matched non-diabetes mellitus patients with a history of stroke or myocardial infarction and a carotid artery stenosis (15%-70%) were included. In all patients, treatment was according to cardiovascular risk management guidelines. At baseline and follow-up, carotid artery vessel wall dimensions were measured using 1.5 T magnetic resonance imaging.
After 2 years of follow-up, total wall volume of the carotid artery in type II diabetes mellitus patients decreased by 9.6% (p = 0.016). In contrast, stabilization rather than regression of carotid artery wall dimensions was observed in non-diabetes mellitus patients over a 2-year period. Body mass index was identified as a predictor of total wall volume decrease.
Guideline treatment arrests atherogenesis in non-diabetes mellitus patients and even decreases vessel wall dimensions in type II diabetes mellitus patients. Baseline body mass index predicts cardiovascular disease prevention efficacy expressed as decrease in total wall volume. These data emphasize the importance of optimal cardiovascular-prevention, particularly in diabetes patients with a high body mass index.
指南推荐的心血管疾病预防方案在2型糖尿病患者和非2型糖尿病患者中的疗效可能有所不同。因此，我们使用磁共振成像比较了有重大心血管疾病事件病史的2型糖尿病患者和非2型糖尿病患者颈动脉壁尺寸的变化。
纳入30例2型糖尿病患者和29例年龄及性别匹配、有中风或心肌梗死病史且存在颈动脉狭窄（15%-70%）的非糖尿病患者。所有患者均按照心血管风险管理指南进行治疗。在基线和随访时，使用1.5T磁共振成像测量颈动脉血管壁尺寸。
经过2年随访，2型糖尿病患者颈动脉的总壁体积减少了9.6%（p = 0.016）。相比之下，在2年期间，非糖尿病患者的颈动脉壁尺寸保持稳定而非缩小。体重指数被确定为总壁体积减少的一个预测因素。
指南治疗可阻止非糖尿病患者的动脉粥样硬化进程，甚至能减小2型糖尿病患者的血管壁尺寸。基线体重指数可预测以总壁体积减少表示的心血管疾病预防疗效。这些数据强调了最佳心血管预防的重要性，尤其是在高体重指数的糖尿病患者中。
