Mrgan Monija, Funck Kristian L, Gaur Sara, Øvrehus Kristian A, Dey Damini, Kusk Martin W, Nørgaard Bjarne L, Gram Jørgen B, Olsen Michael H, Gram Jeppe, Sand Niels Peter R
1 Department of Cardiology, Hospital of Southwest Denmark, Esbjerg, Denmark.
2 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Diab Vasc Dis Res. 2017 Nov;14(6):468-476. doi: 10.1177/1479164117728014. Epub 2017 Sep 2.
The purposes of this study were to compare the presence, extent and composition of coronary plaques in asymptomatic patients with newly diagnosed type 2 diabetes to age- and sex-matched controls.
Patients with newly diagnosed (<1 year) type 2 diabetes ( n = 44) and controls ( n = 44) underwent contrast-enhanced coronary computed tomography angiography. Advanced plaque analysis including total plaque volume and volumes of plaque components (calcified plaque and non-calcified plaque, including low-attenuation [low-density non-calcified plaque]) was performed using validated semi-automated software.
Coronary artery calcification was more often seen in patients with type 2 diabetes (66%) versus controls (48%), p < 0.05. Both the absolute volume (median; interquartile range) of low-density non-calcified plaque (7.9 mm; 0-50.5 mm vs 0; 0-34.3 mm, p < 0.05) and the increase in low-density non-calcified plaque ratio in relation to total plaque volume ( τ = 0.5, p < 0.001) were significantly higher in patients with type 2 diabetes. More patients with type 2 diabetes had spotty calcification (31% vs 0%, p < 0.05). By multivariate analysis, the presence of any low-density non-calcified plaque was higher in males (odds ratio: 4.06, p < 0.05), who also demonstrated a larger low-density non-calcified plaque volume ( p < 0.001). The presence and extent of low-density non-calcified plaque increased with age, smoking, hypertension and hyperglycaemia, all p < 0.05.
Asymptomatic patients with newly diagnosed type 2 diabetes had plaque features associated with increased vulnerability as compared with age- and sex-matched controls.
本研究旨在比较新诊断的2型糖尿病无症状患者与年龄和性别匹配的对照组中冠状动脉斑块的存在情况、范围和组成。
新诊断（<1年）的2型糖尿病患者（n = 44）和对照组（n = 44）接受了对比增强冠状动脉计算机断层扫描血管造影。使用经过验证的半自动软件进行高级斑块分析，包括总斑块体积和斑块成分（钙化斑块和非钙化斑块，包括低衰减[低密度非钙化斑块]）的体积。
2型糖尿病患者中冠状动脉钙化的发生率（66%）高于对照组（48%），p < 0.05。2型糖尿病患者低密度非钙化斑块的绝对体积（中位数；四分位间距）（7.9 mm；0 - 50.5 mm vs 0；0 - 34.3 mm，p < 0.05）以及低密度非钙化斑块占总斑块体积的比例增加（τ = 0.5，p < 0.001）均显著更高。2型糖尿病患者中出现斑点状钙化的更多（31% vs 0%，p < 0.05）。多因素分析显示，男性中任何低密度非钙化斑块的存在比例更高（优势比：4.06，p < 0.05），男性的低密度非钙化斑块体积也更大（p < 0.001）。低密度非钙化斑块的存在和范围随年龄、吸烟、高血压和高血糖而增加，所有p < 0.05。
与年龄和性别匹配的对照组相比，新诊断的2型糖尿病无症状患者具有与易损性增加相关的斑块特征。
