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糖尿病前期和新诊断的 2 型糖尿病患者的颈总动脉内膜中层厚度(CIMT)。

Common carotid artery intima media thickness (CIMT) in patients with prediabetes and newly diagnosed type 2 diabetes mellitus.

机构信息

Medical University Sofia, Internal Medicine Department, Clinic of endocrinology, University Hospital Alexandrovska, Bulgaria.

Medical University Sofia, Internal Medicine Department, Clinic of endocrinology, University Hospital Alexandrovska, Bulgaria.

出版信息

J Diabetes Complications. 2024 Jul;38(7):108766. doi: 10.1016/j.jdiacomp.2024.108766. Epub 2024 May 11.

Abstract

AIM

To evaluate the relationship between common carotid artery intima media thickness (CIMT) in patients with prediabetes and new-onset diabetes mellitus without proven cardiovascular disease and some classic cardio-metabolic risk factors.

PATIENTS AND METHODS

The study included 461 obese patients with an average age of 53.2 ± 10.7 years, divided into three groups - group 1 without carbohydrate disturbances (n = 182), group 2 with prediabetes (n = 193) and group 3 with newly diagnosed diabetes mellitus (n = 86).

RESULTS

The patients with new-onset diabetes had significantly higher mean CIMT values compared to those with prediabetes or without carbohydrate disturbances and a higher frequency of abnormal IMT values. CIMT correlated significantly with age, systolic BP, diastolic BP and fasting blood glucose and showed a high predictive value for the presence of diabetic neuropathy and sudomotor dysfunction. Patients with abnormal CIMT values had a higher incidence of arterial hypertension, dyslipidemia, metabolic syndrome, peripheral neuropathy, and sudomotor dysfunction. Patients who developed type 2 diabetes during follow-up had a significantly higher initial mean CIMT, which showed the highest predictive value for the risk of new-onset diabetes, with CIMT≥0.7 mm having 53 % sensitivity and 83 % specificity for the risk of progression to diabetes mellitus.

CONCLUSION

Patients with new-onset diabetes mellitus had significantly greater intima media thickness of the common carotid artery and a greater frequency of abnormal CIMT values compared to those with normoglycemia and prediabetes. CIMT has a high predictive value for the presence of diabetic neuropathy, sudomotor dysfunction and the risk of new onset diabetes.

摘要

目的

评估无明确心血管疾病的伴或不伴糖代谢受损的糖尿病前期患者与新诊断的糖尿病患者的颈总动脉内膜中层厚度(CIMT)与某些经典心血管代谢危险因素之间的关系。

患者和方法

该研究纳入了 461 名肥胖患者,平均年龄为 53.2±10.7 岁,分为三组:无碳水化合物紊乱组(n=182)、糖尿病前期组(n=193)和新诊断糖尿病组(n=86)。

结果

与糖尿病前期或无碳水化合物紊乱的患者相比,新诊断糖尿病患者的平均 CIMT 值显著更高,且异常 IMT 值的发生率更高。CIMT 与年龄、收缩压、舒张压和空腹血糖显著相关,对糖尿病性神经病变和汗腺功能障碍的存在具有较高的预测价值。CIMT 值异常的患者更易发生高血压、血脂异常、代谢综合征、周围神经病变和汗腺功能障碍。在随访期间发生 2 型糖尿病的患者的初始平均 CIMT 值显著更高,这表明 CIMT 对新发糖尿病的风险具有最高的预测价值,CIMT≥0.7mm 对进展为糖尿病的风险具有 53%的敏感性和 83%的特异性。

结论

与血糖正常和糖尿病前期患者相比,新诊断的糖尿病患者的颈总动脉内膜中层厚度显著增加,且异常 CIMT 值的发生率更高。CIMT 对糖尿病性神经病变、汗腺功能障碍和新发糖尿病的风险具有较高的预测价值。

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