Abstract
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.
Highlights
Atherosclerosis in type 2 diabetes mellitus (T2DM) patients is the major reason of cardiovascular disease and death
The comparisons between the two groups show that the disease duration, BMI, SBP, diastolic blood pressure (DBP), HDL-C, TC, TG, fasting plasma glucose (FPG), postprandial plasma glucose (PPG) or HbA1c are not significantly different (P>0.05) while the difference of LDL-C is statistically significant (P
The results showed that the diagnostic boundary value of Carotid intima-media thickness (CIMT) is 0.9mm which is consistent with the majority of reference while the diagnostic boundary value of pulse wave velocity (PWV) is 1560
Summary
Atherosclerosis in type 2 diabetes mellitus (T2DM) patients is the major reason of cardiovascular disease and death. Arterial calcification and atheromatous plaque are common manifestations of atherosclerosis (AS) [3]. The damage starts from early lesion in intima, followed by thickening of intima-media, the formation of atheromatous plaque, and vascular calcification [4]. Carotid intima-media thickness (CIMT) and atheromatous plaque are early signs for detection of cardiovascular and cerebrovascular atherosclerosis [5]. As an approach of detecting early onset of atherosclerosis, Omron atherosclerosis testing instruments, which are used for non-invasive measurements of atherosclerosis, can measure the ankle-brachial index (ABI) and pulse wave velocity (PWV) [8].
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