Koc Ayse Selcan, Sumbul Hilmi Erdem
Department of Radiology, University of Health Sciences - Adana Health Practices and Research Center, Adana, Turkey.
Department of Internal Medicine, University of Health Sciences - Adana Health Practices and Research Center, Adana, Turkey.
Cardiovasc Ultrasound. 2018 Jun 12;16(1):8. doi: 10.1186/s12947-018-0127-x.
Carotid intima media thickness (C-IMT) and aortic IMT (A-IMT) increase in adult and pediatric patients with diabetes mellitus (DM), respectively. In both age groups IMT is used for early detection of macrovascular complications. In adult DM patients, A-IMT is still not a routine examination and is not used frequently. We aimed to determine whether there is an increase in A-IMT values measured from abdominal aorta besides traditional C-IMT in patients with type II DM and to determine parameters closely related to A-IMT in the same patient group.
We included 114 type II DM patients and 100 healthy control subjects similar in age and sex in our study. Bilateral C-IMT and A-IMT values were measured by B-mode ultrasonography (USG) in addition to anamnesis, physical examination and routine examinations of all patients.
When the clinical, demographic and laboratory data of patients with and without DM were compared, there was a high level of glucose and HbA1c and low hemoglobin levels in the DM patient group. All other parameters were found to be similar between the two groups. When the B-mode USG findings were examined, it was found that C-IMT and A-IMT were increased in patients with DM, with the A-IMT increase being more prominent. A-IMT values were found to be strongly and positively correlated with age, systolic blood pressure, blood urea nitrogen, DM onset time and HbA1c levels, and a negatively and significantly correlated with hemoglobin levels (p < 0.05, for each). In the regression model, the parameters correlating most closely with A-IMT were DM diagnosis onset time, HbA1c and hemoglobin levels (p = 0.001 and β = 0.353, p = 0.014 and β = 0.247 and p < 0.001 and β = - 0.406).
As in pediatric DM patients also in adult DM patients A-IMT can easily be measured with new model USG devices. A-IMT must be measured during abdominal USG which is routine in adult DM patients. A-IMT is an easy, reproducible and non-invasive parameter that may be used in the diagnosis of macrovascular complications of adult type II DM.
糖尿病（DM）成年患者和儿童患者的颈动脉内膜中层厚度（C-IMT）和主动脉内膜中层厚度（A-IMT）分别增加。在这两个年龄组中，内膜中层厚度均用于大血管并发症的早期检测。在成年DM患者中，A-IMT仍非常规检查，且使用频率不高。我们旨在确定在II型DM患者中，除了传统的C-IMT外，腹主动脉测量的A-IMT值是否增加，并确定同一患者组中与A-IMT密切相关的参数。
我们的研究纳入了114例II型DM患者和100例年龄和性别相似的健康对照者。除了对所有患者进行病史采集、体格检查和常规检查外，还通过B型超声检查（USG）测量双侧C-IMT和A-IMT值。
比较DM患者和非DM患者的临床、人口统计学和实验室数据时，DM患者组的血糖和糖化血红蛋白水平较高，血红蛋白水平较低。发现两组之间的所有其他参数相似。检查B型USG检查结果时，发现DM患者的C-IMT和A-IMT增加，其中A-IMT增加更为明显。发现A-IMT值与年龄、收缩压、血尿素氮、DM发病时间和糖化血红蛋白水平呈强正相关，与血红蛋白水平呈负显著相关（每项p<0.05）。在回归模型中，与A-IMT最密切相关的参数是DM诊断发病时间、糖化血红蛋白和血红蛋白水平（p = 0.001，β = 0.353；p = 0.014，β = 0.247；p<0.001，β = -0.406）。
与儿童DM患者一样，成年DM患者也可以使用新型USG设备轻松测量A-IMT。在成年DM患者常规进行的腹部USG检查期间必须测量A-IMT。A-IMT是一种简单、可重复且无创的参数，可用于诊断成年II型DM的大血管并发症。
