Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients
Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients
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DOI：
10.1097/hjh.0b013e328352aba6
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发表时间：
2012-05-01
影响因子：
4.9
通讯作者：
Salles, Gil F.
中科院分区：
文献类型：
--
作者：
Cardoso, Claudia R. L.;Marques, Carlos E. C.;Salles, Gil F.
目的：2型糖尿病患者颈动脉粥样硬化的相关因素尚不清楚。目的是探讨这些individuals.Methods的颈动脉内膜中层厚度（IMT）和斑块的独立相关性：在横断面研究中，我们测量了颈动脉IMT在三个网站（颈总动脉，分叉和颈内动脉）和严重程度颅外颈动脉（ECCA）粥样硬化斑块评分在441例2型糖尿病患者。非传统的心血管危险因素[动态血压（BP），主动脉僵硬度，C-反应蛋白和踝臂指数）。多变量线性回归和Logistic回归分析评估颈动脉IMT和ECCA斑块评分的独立相关性。结果：颈动脉IMT或斑块评分较高的患者比IMT和斑块评分较低的患者的临床和实验室资料较差，包括较高的血压、主动脉僵硬度和糖尿病并发症的患病率。多因素分析显示，颈动脉IMT和斑块主要与年龄、男性、既往吸烟和动态血压相关，而与临床血压无关。夜间脉压是颈动脉IMT增加的最重要的可变决定因素。除视网膜病变斑块评分外，无微血管并发症与颈动脉粥样硬化独立相关。此外，颈内动脉IMT和斑块评分与踝肱指数在亚组的患者无macrovascular diseases.Conclusion：在2型糖尿病患者，年龄较大，男性，吸烟状况和动态血压，特别是夜间脉压，是主要的独立相关超声颈动脉粥样硬化。这一发现强调了动态血压监测在2型糖尿病管理中的重要性。
Objective: Factors associated with carotid atherosclerosis are unclear in type 2 diabetic patients. The aim was to investigate the independent correlates of carotid intima-media thickness (IMT) and plaques in these individuals.Methods: In a cross-sectional study, we measured carotid IMT at three sites (common carotid, bifurcation and internal carotid artery) and the severity of extracranial carotid artery (ECCA) atherosclerosis by plaque score in 441 type 2 diabetic patients. Nontraditional cardiovascular risk factors [ambulatory blood pressures (BPs), aortic stiffness, C-reactive protein and ankle-brachial index) were obtained. Multivariate linear and logistic regressions assessed the independent correlates of carotid IMT and ECCA plaque score.Results: Patients with greater carotid IMT or plaque scores had worse clinical and laboratory profile than those with lower IMT and plaque scores, including higher BPs, aortic stiffness and prevalences of diabetic complications. On multivariate analysis, carotid IMT and plaques were mainly associated with older age, male sex, current-past smoking and ambulatory BPs, but not with clinic BPs. Night-time pulse pressure was the most important modifiable determinant of increased carotid IMT. No microvascular complication was independently associated with carotid atherosclerosis, except retinopathy for plaque score. Additionally, internal carotid IMT and plaque score were associated with ankle-brachial index in the subgroup of patients without macrovascular diseases.Conclusion: In type 2 diabetic patients, older age, male sex, smoking status and ambulatory BPs, particularly night-time pulse pressure, were the main independent correlates of ultrasonographic carotid atherosclerosis. This finding reinforces the importance of ambulatory BP monitoring in type 2 diabetes management.