Carotid intima-media thickness in patients with Type 2 diabetes and hypercholesterolemia.
Carotid intima-media thickness in patients with Type 2 diabetes and hypercholesterolemia.
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2 型糖尿病合并高胆固醇血症患者的颈动脉内膜中层厚度。
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
A. Lala
中科院分区：
文献类型：
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作者：
F. Montecchi;G. Menzinger;A. Lala
与一般人群相比，2型糖尿病（T2 DM）和高胆固醇血症患者的颈总动脉内膜中层厚度（CIMT）值更高，动脉粥样硬化更广泛，更加速。本研究的目的是比较多基因高胆固醇血症（HP; n=41：30名女性和11名男性，年龄52+/-15岁）和T2 DM（n=43：22名女性和21名男性，年龄59+/-11岁）患者的CIMT，疾病持续时间小于5年，无冠心病证据。研究了40名性别和年龄匹配的健康受试者的对照组（C）。我们评价了无斑块部位颈总动脉远段远壁的CIMT。CIMT测量值的平均值（Tmean;每侧9）和测量的最大CIMT（Tmax）用作每例受试者的代表值。T2 DM和HP的Tmax值分别为0.96+/-0.2 mm和0.82+/-0.2 mm，显著高于C组（0.74+/-0.1 mm）。T平均值的相应值为0.8+/-0.1 mm和0.71+/-0.2 mm，均显著高于C组（0.68+/-0.1 mm）。在HP中，Tmax和Tmean值均与年龄呈正相关（分别为p=0.0001和p=0.0001），体重指数（BMI;分别为p=0.05和p=0.05），存在高血压（分别为p=0.003和p=0.0008）和纤维蛋白原（分别为p=0.0009和p=0.001）; Tmean也与载脂蛋白B（Apo B; p=0.03）相关。多元逐步回归分析显示纤维蛋白原和年龄是Tmax和Tmean的唯一重要决定因素。在T2 DM中，Tmax和Tmean仅与年龄呈正相关（分别为p=0.04和p=0.01）。总之，T2 DM患者的动脉粥样硬化比HP受试者更快。这在短时间的疾病后是明显的，可能是疾病的较长潜伏期和多种风险因素的存在。
Both patients with Type 2 diabetes mellitus (T2DM) and with hypercholesterolemia have a more extensive and accelerated atherosclerosis with higher common carotid artery intima-media thickness (CIMT) values than the general population. The aim of this study was to compare the CIMT in polygenic hypercholesterolemia (HP; n=41: 30 females and 11 males, aged 52+/-15 yr) and in T2DM (n=43: 22 females and 21 males, aged 59+/-11 yr), with a duration of disease less than 5 yr and no evidence of coronary heart disease. A control group (C) of 40 sex- and age-matched healthy subjects was studied. We evaluated the CIMT on the far wall of the distal segment of the common carotid arteries on sites free of plaque. The mean of the CIMT measurements (Tmean; 9 on each side) and the maximal CIMT measured (Tmax) were used as the representative values for each subject. Tmax values were 0.96+/-0.2 mm and 0.82+/-0.2 mm in T2DM and HP, respectively, which were significantly higher than C (0.74+/-0.1 mm). Corresponding values of Tmean were 0.8+/-0.1 mm and 0.71+/-0.2 mm, both significantly higher than C (0.68+/-0.1 mm). In HP, both Tmax and Tmean values were positively correlated to age (p=0.0001 and p=0.0001, respectively), body mass index (BMI; p=0.05 and p=0.05, respectively), presence of hypertension (p=0.003 and p=0.0008, respectively) and fibrinogen (p=0.0009 and p=0.001, respectively); Tmean was also correlated to apolipoprotein B (ApoB; p=0.03). The multiple "stepwise" regression analysis revealed fibrinogen and age as the only significant determinants of Tmax and Tmean. In T2DM Tmax and Tmean were positively correlated to age only (p=0.04 and p=0.01, respectively). In conclusion, T2DM patients have a more accelerated atherosclerosis than subjects with HP. This is evident after a short duration of disease, probably for a longer latency period of disease and the presence of multiple risk factors.