2型糖尿病无症状受试者的亚临床颈动脉粥样硬化
Subclinical Carotid Atherosclerosis in Asymptomatic Subjects With Type 2 Diabetes Mellitus.
作者信息
Rubinat Esther, Marsal Josep Ramon, Vidal Teresa, Cebrian Cristina, Falguera Mireia, Vilanova Ma Belen, Betriu Àngels, Fernández Elvira, Franch Josep, Mauricio Dídac
机构信息
Esther Rubinat, RN, MSc Research Nurse, PhD Student, Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova; and Institut de Recerca Biomèdica de Lleida, University of Lleida, Spain. Josep Ramon Marsal, Stat Statistician, Unitat de Suport a la Recerca de Lleida, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIA Jordi Gol), Lleida; and Unitat de Epidemiologia, Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Teresa Vidal, RN Nurse, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova; and Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Cristina Cebrian, RN Nurse, Primary Health Care Center Primer de Maig, Lleida, Spain. Mireia Falguera, MD General Practitioner, Primary Health Care Center Igualada Nord, Spain. Ma. Belen Vilanova, MD General Practitioner, Primary Health Care Center Igualada Nord, Spain. Àngels Betriu, MD, PhD Coordinator, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova; and Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Elvira Fernández, MD, PhD Head of Department and Associate Professor, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova; and Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Josep Franch, MD, PhD General Practitioner, Primary Health Care Center Raval Sud; and Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain. Dídac Mauricio, MD, PhD Chief Physician, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova, Lleida; Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona; and Department of Endocrinology and Nutrition, Hospital Germans Trias Pujol, Badalona, Spain.
出版信息
J Cardiovasc Nurs. 2016 Mar-Apr;31(2):E1-7. doi: 10.1097/JCN.0000000000000236.
BACKGROUND
Subjects with type 2 diabetes mellitus are considered to be at high risk for cardiovascular disease. The identification of carotid atherosclerosis is a validated surrogate marker of cardiovascular disease. Nurses are key professionals in the improvement and intensification of cardiovascular preventive strategies.
AIMS
The aim is to study the presence of carotid atherosclerosis in a group of asymptomatic subjects with type 2 diabetes mellitus and no previous clinical cardiovascular disease.
METHODS
A total of 187 patients with type 2 diabetes mellitus and 187 age- and sex-matched subjects without type 2 diabetes mellitus were studied in this cross-sectional, observational, cohort study. Standard operational procedures were applied by the nursing team regarding physical examination and carotid ultrasound assessment. Common, bulb, and internal carotid arteries were explored by measuring intima-media thickness and identifying atherosclerotic plaques.
RESULTS
Carotid intima-media thickness (c-IMT) and carotid plaque prevalence were significantly greater in diabetic subjects than in the control group. Carotid plaques and c-IMT were more frequent in men than in women and increased with increasing age. In the multivariate analysis, age, gender, waist circumference, systolic blood pressure, and hypercholesterolemia were positively associated with c-IMT, whereas age, gender, and weight were positively associated with carotid plaque.
CONCLUSION
The current nurse-led study shows that subjects with type 2 diabetes mellitus have a high prevalence of subclinical atherosclerosis that is associated with cardiovascular risk factors.
背景
2型糖尿病患者被认为具有较高的心血管疾病风险。颈动脉粥样硬化的识别是心血管疾病的一个经过验证的替代标志物。护士是改善和强化心血管预防策略的关键专业人员。
目的
旨在研究一组无症状的2型糖尿病且既往无临床心血管疾病患者中颈动脉粥样硬化的情况。
方法
在这项横断面观察性队列研究中，共研究了187例2型糖尿病患者和187例年龄及性别匹配的非2型糖尿病患者。护理团队采用标准操作程序进行体格检查和颈动脉超声评估。通过测量内膜中层厚度并识别动脉粥样硬化斑块来探查颈总动脉、颈动脉球部和颈内动脉。
结果
糖尿病患者的颈动脉内膜中层厚度（c-IMT）和颈动脉斑块患病率显著高于对照组。颈动脉斑块和c-IMT在男性中比女性更常见，且随年龄增长而增加。在多变量分析中，年龄、性别、腰围、收缩压和高胆固醇血症与c-IMT呈正相关，而年龄、性别和体重与颈动脉斑块呈正相关。
结论
当前由护士主导的研究表明，2型糖尿病患者亚临床动脉粥样硬化的患病率较高，且与心血管危险因素相关。
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