Le Tuan Dinh, Nguyen Nga Phi Thi, Nguyen Son Tien, Nguyen Hien Thi, Tran Hoa Thanh Thi, Nguyen Thi Ho Lan, Nguyen Cuong Duy, Nguyen Giang Thi, Nguyen Xuan Thanh, Nguyen Bac Duy, Trinh Son The, Ngo Tuan Anh, Do Binh Nhu, Luong Thuc Cong
Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam.
Department of Endocrinology, Military Hospital 103, Ha Noi, Vietnam.
Diabetes Metab Syndr Obes. 2020 Oct 7;13:3561-3570. doi: 10.2147/DMSO.S264876. eCollection 2020.
Endothelium dysfunction and decrease of incretin effects occur early in type 2 diabetes mellitus and these changes contribute to diabetic cardiovascular complications such as atherosclerosis, thick intima-media, coronary, and peripheral arterial diseases. In patients with diabetes, the femoral artery is a site of a high incidence of injury in peripheral vascular diseases, and atherosclerotic changes may appear earlier in the femoral artery compared to the carotid artery. This study was conducted to determine the prevalence of increased femoral artery intima-media thickness (IMT) and atherosclerotic plaque and their correlation with serum glucagon-like peptide-1 (GLP-1) levels in newly-diagnosed patients with type 2 diabetes mellitus.
A cross-sectional study was conducted on 332 patients with nT2D in the National Endocrinology Hospital, Vietnam from January 2015 to May 2018. IMT was measured by Doppler ultrasound and GLP-1 by enzyme-linked immunosorbent assay (ELISA). All data were analyzed with SPSS version 26 for Windows (SPSS Inc, Chicago, IL).
Prevalence of thick femoral artery IMT and atherosclerotic plaque was 38.2 and 22.3%, respectively. There was a relationship between IMT and age, waist to hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting GLP-1, high sensitive CRP (hsCRP) and 24-hour microalbuminuria secretion (24-h MAUS). The fasting serum GLP-1 (fGLP-1) levels were reduced significantly in patients with thickness and atherosclerosis femoral artery (p = 0.001). After adjusting with other related factors, namely, DBP and estimated glomerular filtration rate (eGFR), whilst hsCRP and 24-h MAUS showed a significantly positive correlation to IMT (Standardized B and p of 0.242, 0.004 and 0.178, 0.043, respectively), fGLP-1 showed a significantly negative correlation to IMT (Standardized B = -0.288, p = 0.001).
Among n2TD, the percentage for femoral artery thick IMT and atherosclerosis was 38.2% and 22.3% respectively, and serum GLP-1 was negatively correlated with thick IMT and atherosclerosis.
内皮功能障碍和肠促胰岛素效应降低在2型糖尿病早期就会出现，这些变化会导致糖尿病心血管并发症，如动脉粥样硬化、内膜中层增厚、冠状动脉疾病和外周动脉疾病。在糖尿病患者中，股动脉是外周血管疾病损伤的高发部位，与颈动脉相比，股动脉的动脉粥样硬化变化可能更早出现。本研究旨在确定新诊断的2型糖尿病患者股动脉内膜中层厚度（IMT）增加和动脉粥样硬化斑块的患病率及其与血清胰高血糖素样肽-1（GLP-1）水平的相关性。
2015年1月至2018年5月，在越南国家内分泌医院对332例新诊断2型糖尿病（nT2D）患者进行了一项横断面研究。通过多普勒超声测量IMT，通过酶联免疫吸附测定（ELISA）测量GLP-1。所有数据均使用适用于Windows的SPSS 26版软件（SPSS公司，伊利诺伊州芝加哥）进行分析。
股动脉IMT增厚和动脉粥样硬化斑块的患病率分别为38.2%和22.3%。IMT与年龄、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、空腹GLP-1、高敏C反应蛋白（hsCRP）和24小时微量白蛋白尿分泌（24-h MAUS）之间存在关联。股动脉增厚和动脉粥样硬化患者的空腹血清GLP-1（fGLP-1）水平显著降低（p = 0.001）。在对其他相关因素进行校正后，即DBP和估计肾小球滤过率（eGFR），虽然hsCRP和24-h MAUS与IMT呈显著正相关（标准化B值和p值分别为0.242、0.004和0.178、0.043），但fGLP-1与IMT呈显著负相关（标准化B = -0.288，p = 0.00）。
在新诊断2型糖尿病患者中，股动脉IMT增厚和动脉粥样硬化的比例分别为38.2%和22.3%，血清GLP-1与IMT增厚和动脉粥样硬化呈负相关。
