Kanters S D, Algra A, Banga J D
Department of Internal Medicine, University Hospital, Utrecht, The Netherlands.
Diabetes Care. 1997 Mar;20(3):276-80. doi: 10.2337/diacare.20.3.276.
Ultrasonographic measurements of the combined thickness of the carotid intima and media can be used to examine early vessel wall changes in atherosclerosis. Premature atherosclerosis is common in diabetes, especially when other risk factors are present. Intima-media thickness was quantified in hyperlipidemic type I and type II diabetic patients, and relationships between various risk factors and intima-media thickness were investigated.
Thirty-one patients with type I diabetes and 56 with type II diabetes were examined, with an LDL cholesterol of > 2.6 mmol/l and/or triglycerides of > 1.7 mmol/l and/or HDL cholesterol of < 0.9 mmol/l for men or < 1.1 mmol/l for women. Intima-media thickness was measured on-line, over a length of 1 cm in the common carotid artery. Later, the mean and the maximum of six measurements was calculated (left and right side, both in three directions).
Mean intima-media thickness was 0.63 +/- 0.18 (+/-SD) mm for type I diabetes and 0.80 +/- 0.31 mm for type II diabetes. Adjusted for age, the difference was 0.06 mm, with a 95% CI of -0.08 to 0.20 mm. In multivariate regression analysis, age over 50 years and higher HbA1c were independently associated with an increase in mean intima-media thickness in type I diabetes. In type II diabetes, none of the variables reached a significance level of < or = 0.10. Results for maximum intima-media thickness were essentially the same.
In general, intima-media thickness is larger in type II diabetes than in type I diabetes. The effect of age is absent in type II diabetes, whereas in type I diabetes, age and blood glucose control have an important effect on intima-media thickness.
超声测量颈动脉内膜和中膜的联合厚度可用于检查动脉粥样硬化早期血管壁的变化。过早出现动脉粥样硬化在糖尿病患者中很常见，尤其是存在其他危险因素时。对I型和II型糖尿病高脂血症患者的内膜中层厚度进行量化，并研究各种危险因素与内膜中层厚度之间的关系。
对31例I型糖尿病患者和56例II型糖尿病患者进行检查，其低密度脂蛋白胆固醇>2.6 mmol/l和/或甘油三酯>1.7 mmol/l和/或男性高密度脂蛋白胆固醇<0.9 mmol/l或女性<1.1 mmol/l。在颈总动脉1 cm长度上在线测量内膜中层厚度。随后，计算六次测量的平均值和最大值（左右两侧，三个方向）。
I型糖尿病患者的平均内膜中层厚度为0.63±0.18（±标准差）mm，II型糖尿病患者为0.80±0.31 mm。经年龄调整后，差异为0.06 mm，95%可信区间为-0.08至0.20 mm。在多变量回归分析中，50岁以上年龄和较高的糖化血红蛋白与I型糖尿病患者平均内膜中层厚度增加独立相关。在II型糖尿病中，没有一个变量达到≤0.10的显著水平。最大内膜中层厚度的结果基本相同。
一般来说，II型糖尿病患者的内膜中层厚度大于I型糖尿病患者。年龄对II型糖尿病患者没有影响，而在I型糖尿病中，年龄和血糖控制对内膜中层厚度有重要影响。
