Analysis of Status and Risk Factors for Macrovascular Complications in Type 2 Diabetes Mellitus
International Journal of Clinical and Experimental Medical Sciences
Volume 4, Issue 3, May 2018, Pages: 39-45
Received: Jun. 9, 2018;
Accepted: Jun. 26, 2018;
Published: Aug. 24, 2018
Views 1518 Downloads 65
Rui Han, Department of Diabetes, the First Affliated Hospital of Kunming Medical University, Kunming, China
Wei Yang, Department of Diabetes, the First Affliated Hospital of Kunming Medical University, Kunming, China
Dan Yang, Department of Diabetes, the First Affliated Hospital of Kunming Medical University, Kunming, China
Xia Dong, Department of Diabetes, the First Affliated Hospital of Kunming Medical University, Kunming, China
Lin Song, Department of Diabetes, the First Affliated Hospital of Kunming Medical University, Kunming, China
Hua Liu, Department of Diabetes, the First Affliated Hospital of Kunming Medical University, Kunming, China
The status and risk factors for atherosclerosis (AS) were investigated and the sensitivity and accuracy of existing examine methods of AS were evaluated in patients with diabetes mellitus(T2DM). Ninety nine patients who diagnosed with the WHO 1999 criteria for T2DM were enrolled in this study, which were divided into atherosclerotic group(group A) and non-atherosclerosis group(group B). The clinical characteristics, including fasting plasma glucose(FPG), postprandial plasma glucose(PPG), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), glycosylated hemoglobin A1c(HbAlc) and early examination methods of AS, including carotid intima-media thickness(CIMT), ankle brachial index(ABI) and pulse wave velocity (PWV) were recorded. The t-test, χ2 test or linear regression model were used for retrospective analyses then showed that the prevalence rate of carotid plaque was 29.3%( 29/99), there is no difference between the distribution of age and gender in the group with or without plaque (χ2 = 0.044, P>0.05; t = 0.850, P>0.05). It also demonstrated that systolic blood pressure(SBP), diastolic blood pressure (DBP), LDL-C, CIMT, history of smoke were significantly higher in plaques group than that of without plaques ( P＜0.05). Logistic analysis showed that LDL-C and CIMT were independent risk factors for incidence of cervical atheromatous plaques in type 2 diabetic patients (P＜0.05). The risk of AS has increased by 1.7 times by every unit of LDL-C, as well as increased by 13.8 times by every unit of CIMT. CIMT and PWV, but not ABI, are valuable for AS diagnosing. According to sensitivity and specificity, the best diagnostic value for CIMT is 0.9mm and for PWV is 1560.As a result, LDL-C and CIMT are independent risk factors for AS. Early intervention and controlling of risks factors will have clinical value for prevention and treatment of macrovascular diseases in T2DM. The corresponding cut-off points 1560 of PWV is better than 1400 for diagnosis of AS in this hospital.
Analysis of Status and Risk Factors for Macrovascular Complications in Type 2 Diabetes Mellitus, International Journal of Clinical and Experimental Medical Sciences.
Vol. 4, No. 3,
2018, pp. 39-45.
Khazai B, Luo Y, Rosenberg S, et al. Coronary Atherosclerotic Plaque Detected by Computed Tomographic Angiography in Subjects with Diabetes Compared to Those without Diabetes. Plos One. 2015; 10:e0143187.
Yahagi K, Kolodgie F D, Lutter C, et al. Pathology of Human Coronary and Carotid Artery Atherosclerosis and Vascular Calcification in Diabetes Mellitus. Arteriosclerosis Thrombosis & Vascular Biology. 2017; 37:191.
Farrag A, Bakhoum S, Salem M A, et al. The association between extracoronary calcification and coronary artery disease in patients with type 2 diabetes mellitus. Heart & Vessels. 2013; 28:12-18.
Madonna R, De Caterina R. Cellular and molecular mechanisms of vascular injury in diabetes--part II: cellular mechanisms and therapeutic targets. Vascular Pharmacology. 2011; 54:75-79.
Rundek T, Gardener H, Della-Morte D, et al. The Relationship between Carotid Intima-Media Thickness and Carotid Plaque in the Northern Manhattan Study. Atherosclerosis. 2015; 241:364-370.
Steinl D C, Kaufmann B A. Ultrasound imaging for risk assessment in atherosclerosis. International Journal of Molecular Sciences. 2015; 16:9749-9769.
Laurent S, Boutouyrie P. Arterial stiffness: a new surrogate end point for cardiovascular disease?. J Nephrol. 2007; 20 Suppl 12:S45-50.
Katakami N, Osonoi T, Takahara M, et al. Clinical utility of brachial-ankle pulse wave velocity in the prediction of cardiovascular events in diabetic patients. Cardiovascular Diabetology. 2014; 13:1-11.
Maeda Y, Inoguchi T, Etoh E, et al. Brachial-ankle pulse wave velocity predicts all-cause mortality and cardiovascular events in patients with diabetes: the Kyushu Prevention Study of Atherosclerosis. Diabetes Care. 2014; 37:2383.
Ninomiya T, Kojima I, Doi Y, et al. Brachial-ankle pulse wave velocity predicts the development of cardiovascular disease in a general Japanese population: the Hisayama Study. Journal of Hypertension. 2013; 31:477-483.
Youheng W, Wei Y, Junpeng F. Analysis of influence factors and the observation of carotid atherosclerosis in type 2 diabetic patients. Shaanxi Medical Journal. 2012; 41:451-453.
Wang H Y, Da yi H U, Zhu T G. Study of Relationship between Coronary Lesion and the Large Artery Structure and Function. Chinese Journal of Medical Imaging Technology. 2002; 18:1230-1232.
Yan-Li H U, Zhao-Ping L I, Zhang H X, et al. Evaluation of early arteriosclerosis in patients with diabetes mellitus by several non-invasive methods. Chinese Journal of Cardiovascular Medicine. 2010; 15:206-209.
Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation. 1993; 87:II56-65.
Basta G, Schmidt A M, De C R. Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes. Cardiovascular Research. 2004; 63:582.
Wu, Yan, He, et al. Carotid atherosclerosis and its relationship to coronary heart disease and stroke risk in patients with type 2 diabetes mellitus. Medicine. 2017; 96:e8151.
Kawamoto R, Tomita H, Oka Y, Ohtsuka N. Relationship between serum uric acid concentration, metabolic syndrome and carotid atherosclerosis. Intern Med. 2006; 45:605-614.
Nagahama K, Iseki K, Inoue T, Touma T, Ikemiya Y, Takishita S. Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan. Hypertens Res. 2004; 27:227-233.
Li Q, Yang Z, Lu B, et al. Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes. Cardiovascular Diabetology. 2011; 10:72-72.
Bittencourt C, Piveta V M, Oliveira C S, et al. Association of classical risk factors and coronary artery disease in type 2 diabetic patients submitted to coronary angiography. Diabetology & Metabolic Syndrome. 2014; 6:1-8.
Yanhong W, Pingping L, Jun W. Related risk analysis of factors for carotid atherosclerotic plaque in type 2 diabetes mellitus patients with cerebral infarction. Chinese Journal of Integrative Medicine on Cardio/Cerebrovascular Disease. 2012; 10:433-434.
Hui C, Liming Y. Interventional treatment of acute occlusion of limb arteries after trauma. CONTEMPORARY MEDICINE. 2011; 17:57-58.
Xiao-Li X U, Xiong J Q, Heng-Qing L I, et al. Echo-tracking technique for assessing carotid artery elasticity in patients with type 2 diabetes mellitus and hyperlipidemia. Journal of Practical Medicine. 2009; 25:1583-1585.
Li Q, Zeng H, Liu F, et al. High Ankle-Brachial Index Indicates Cardiovascular and Peripheral Arterial Disease in Patients With Type 2 Diabetes. Angiology. 2015; 66:918.
Ter A E, Stalenhoef A F, De G J. What is the role of non-invasive measurements of atherosclerosis in individual cardiovascular risk prediction? Clinical Science. 2007; 112:507-516.
Lunder M. Associations among different functional and structural arterial wall properties and their relations to traditional cardiovascular risk factors in healthy subjects: a cross-sectional study. Bmc Cardiovascular Disorders. 2012; 12:29.