Peppa-Patrikiou M, Scordili M, Antoniou A, Giannaki M, Dracopoulou M, Dacou-Voutetakis C
Diabetes Center, Athens University Medical School, Greece.
Diabetes Care. 1998 Jun;21(6):1004-7. doi: 10.2337/diacare.21.6.1004.
To investigate 1) alterations of carotid intimal-plus-medial thickness (IMT) in subjects with IDDM and 2) the relation of IMT to indexes of diabetic angiopathy and to risk factors of atherosclerosis.
IMT was assessed by ultrasound B-mode imaging in 39 subjects with IDDM (23 male, 16 female young adults aged 17.5 +/- 5.2 years, diabetes duration 8.8 +/- 5.9) and in 22 control subjects (healthy siblings of the IDDM subjects) of comparable age. Urinary endothelin (UET1) and urinary free cortisol (UFC) were determined by radioammunoassay (RIA), urinary albumin by nephelometry, HbA1c by high-performance liquid chromatography (HPLC), and plasma renin by immunoradiometric assay (IRMA).
The IMT values were greater in IDDM subjects than in control subjects (0.49 +/- 0.1 mm, 0.44 +/- 0.09 mm, respectively; P = 0.048) and greater in IDDM male subjects than in control male subjects (0.52 +/- 0.09 and 0.44 +/- 0.06 mm, respectively; P = 0.015), with no difference between IDDM and control female subjects. The IMT values were greater in diabetic male subjects than in female subjects (0.52 +/- 0.09 and 0.45 +/- 0.1 mm, respectively; P = 0.017). In IDDM subjects, but not in control subjects, there was a positive correlation of IMT to urinary albumin (P = 0.008), systolic blood pressure (P = 0.023), UET1 (P = 0.016), UFC (P = 0.002), and BMI (P = 0.021). Multiple regression analysis demonstrated that in IDDM subjects the variable that interacts independently with IMT was the BMI (P = 0.001).
IMT, an index of atherosclerosis (macroangiopathy), is increased in IDDM subjects quite early (already in adolescence), and it is positively related to urinary albumin, UET1, blood pressure, and UFC.
1）研究1型糖尿病患者颈动脉内膜中层厚度（IMT）的变化；2）研究IMT与糖尿病血管病变指标及动脉粥样硬化危险因素之间的关系。
采用B型超声成像评估39例1型糖尿病患者（男23例，女16例；年轻成年人，年龄17.5±5.2岁，糖尿病病程8.8±5.9年）及22例年龄匹配的对照者（1型糖尿病患者的健康同胞）的IMT。采用放射免疫分析法（RIA）测定尿内皮素（UET1）和尿游离皮质醇（UFC），用散射比浊法测定尿白蛋白，用高效液相色谱法（HPLC）测定糖化血红蛋白（HbA1c），用免疫放射分析法（IRMA）测定血浆肾素。
1型糖尿病患者的IMT值高于对照者（分别为0.49±0.1mm和0.44±0.09mm；P=0.048），1型糖尿病男性患者的IMT值高于对照男性患者（分别为0.52±0.09mm和0.44±0.06mm；P=0.015），1型糖尿病女性患者与对照女性患者之间无差异。糖尿病男性患者的IMT值高于女性患者（分别为0.52±0.09mm和0.45±0.1mm；P=0.017）。在1型糖尿病患者中，而非对照者中，IMT与尿白蛋白（P=0.008）、收缩压（P=0.023）、UET1（P=0.016）、UFC（P=0.002）及体重指数（BMI）（P=0.021）呈正相关。多元回归分析表明，在1型糖尿病患者中，与IMT独立相关的变量是BMI（P=0.001）。
IMT作为动脉粥样硬化（大血管病变）的一个指标，在1型糖尿病患者中相当早（青春期就已出现）就升高，且与尿白蛋白、UET1、血压及UFC呈正相关。
