Inflammation and coronary angiography in asymptomatic type 2 diabetic subjects
Inflammation and coronary angiography in asymptomatic type 2 diabetic subjects
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DOI：
10.1080/00365510601045088
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发表时间：
2007-01-01
影响因子：
2.1
通讯作者：
Gullestad, L.
中科院分区：
文献类型：
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作者：
Johansen, O. E.;Birkeland, K. I.;Gullestad, L.
目标。冠状动脉疾病(CAD)在2型糖尿病(T2 DM)患者中很常见，由于与非糖尿病患者的CAD相比，它通常没有症状且范围广泛，因此对诊断构成了挑战。本研究的目的是通过血管造影术调查无症状T2 DM患者中冠心病的患病率，并探讨其与心血管危险因素、代谢综合征和炎症标志物的关系。材料和方法。82例T2 DM患者无冠心病症状，且有1个心血管危险因素(高血压、血脂异常、早产性冠心病、吸烟或微量白蛋白尿)，接受了诊断性负荷试验和冠状动脉造影，而不考虑负荷试验结果。冠状动脉主干的狭窄被归类为单支、双支或三支病变，管腔直径的50%。分析空腹标本中的炎性标志物。结果。男性15例，女性2例(21%)(1支病变10例，2支或3支病变7例)。有2支或3支血管病变的患者明显年龄较大，糖尿病病程较长，但其他传统心血管危险因素或代谢综合征的患病率在1支或2支或3支血管病变的患者中相似。负荷试验对CAD的敏感性较低(0.35)。与无冠脉或单支冠脉病变的患者相比，2-3支冠脉病变患者的促炎标志物白介素6的平均水平升高(p<；0.05)。结论。在无症状的T2 DM患者中，有21%的患者存在明显的冠心病，且有1个心血管危险因素。炎症标记物可能有助于识别可能患有显著冠心病的患者，但需要进行更大规模的研究。
Objective. Coronary artery disease (CAD) is prevalent in patients with type 2 diabetes mellitus (T2DM) and because it is often asymptomatic and extensive in comparison with CAD in subjects without diabetes, it represents a diagnostic challenge. The objective of the study was to investigate the prevalence of CAD in asymptomatic T2DM patients utilizing angiography and to investigate its association with cardiovascular (CV) risk factors, the metabolic syndrome and markers of inflammation. Material and methods. Eighty-two patients with T2DM without symptoms of CAD, and with >= 1 CV risk factor (hypertension, dyslipidaemia, premature familial CAD, smoking or microalbuminuria) underwent a diagnostic stress test and coronary angiography irrespective of stress test results. Stenosis detected in the main coronary arteries >= 50% of lumen diameter was categorized as one-, two- or three-vessel disease. Inflammatory markers were analysed in fasting samples. Results. Fifteen men and two women had significant CAD (21 %) (1-vessel disease, n=10; 2- or 3-vessel disease, n=7). Patients with 2- or 3-vessel disease were significantly older and had a longer duration of diabetes, but the prevalence of other traditional CV risk factors or the metabolic syndrome was similar among those with 1-vessel and those with 2- or 3-vessel disease. Sensitivity for CAD of the stress test was low (0.35). The mean level of the pro-inflammatory marker interleukin-6 was elevated in patients with 2- to 3-vessel CAD as compared to patients with no or 1-vessel CAD (p < 0.05). Conclusions. Significant CAD was found in 21% of asymptomatic patients with T2DM with >= 1 CV risk factor. Inflammatory markers may be helpful in identifying patients that are likely to have significant CAD, but larger studies are warranted.