Department of Endocrinology, Yunus Emre State Hospital, Eskisehir, Turkey.
Department of Endocrinology, Yunus Emre State Hospital, Eskisehir, Turkey.
J Natl Med Assoc. 2017;109(1):14-20. doi: 10.1016/j.jnma.2017.01.003. Epub 2017 Jan 27.
Increased carotid intima media thickness indicates subclinical atherosclerosis. We evaluated the relation between vitamin D level and intima media thickness in patients with type 1 DM. 93 patients (female/male: 48/45, aged 31.5 ± 11.9 years, A1c 9.48 ± 2.43, vitamin D [15.9 (12.1-19.2)]) with type 1 DM were included into the study. Common carotid artery IMT was measured by real time B mode ultrasonography (MyLab 70 XVG, Esaote SpA, Genoa, Italy). Vitamin D was measured using radioimmunassay. Male and female patients (n = 14, 15%) had similar rates of plaque presence (p = 0.377). IMT was similar according to gender. IMT [0.45 (0.40-0.50)] was positively correlated with age, duration of diabetes, creatinine, LDL/HDL ratio, and ALP. Median IMT was higher in current smokers, patients with retinopathy, and nephropathy, and overweight/obese patients. IMT was not different according to vitamin D status. However calcium level corrected for albumin was in positive correlation with mean IMT (r = 0.221, p = 0.033). We detected high frequency of vitamin D deficiency (78%) defined as less than 20 ng/ml. Vitamin D and diabetes control defined as A1c have no effect on intima media thickness in type 1 DM. Traditional cardiovascular risk factors including age, duration of DM, smoking, and BMI adversely affect intima media thickness.
颈动脉内膜中层厚度增加表明亚临床动脉粥样硬化。我们评估了 1 型糖尿病患者维生素 D 水平与内膜中层厚度之间的关系。研究纳入 93 例 1 型糖尿病患者（女/男：48/45 例，年龄 31.5±11.9 岁，A1c9.48±2.43，维生素 D[15.9（12.1-19.2）]）。应用实时 B 型超声（MyLab 70 XVG，Esaote SpA，意大利热那亚）测量颈总动脉内膜中层厚度。应用放射免疫分析法测量维生素 D。男性和女性患者（n=14，15%）斑块发生率相似（p=0.377）。根据性别，内膜中层厚度相似。IMT[0.45（0.40-0.50）]与年龄、糖尿病病程、肌酐、LDL/HDL 比值和 ALP 呈正相关。当前吸烟者、视网膜病变和肾病患者以及超重/肥胖患者的平均 IMT 较高。维生素 D 状况与 IMT 无差异。然而，白蛋白校正钙水平与平均 IMT 呈正相关（r=0.221，p=0.033）。我们检测到维生素 D 缺乏（定义为小于 20ng/ml）的高发率（78%）。1 型糖尿病患者的维生素 D 和糖尿病控制（定义为 A1c）对内膜中层厚度无影响。年龄、糖尿病病程、吸烟和 BMI 等传统心血管危险因素对内膜中层厚度有不利影响。
