ATHEROSCLEROSIS AND INCIPIENT NEPHROPATHY IN DIABETIC PATIENTS

Abstract

Objective: The association between nephropathy, particularly microalbuminuria, and cardiovascular disease, is becoming increasingly apparent. Atherosclerotic process is a combination of fatty degeneration (atherosis) and of vessel stiffening (sclerosis) of the arterial wall. The aim of the study was to assess relationship between diabetic nephropathy and structural changes in arteries, such as carotid intima – media thickness (IMT). Design and method: We selected 80 adults with type 2 diabetes. 47 were women and 33 were men, mean age 51 ± 14. They were divided into three groups based on albuminuria status: Group I = no albuminuria (<30 mg albumin/g creatinine), numbers of patients 27; Group II = microalbuminuria (30 to 300 mg/g) numbers of patients 26; and Group III = macroalbuminuria (>300 mg/g) numbers of patients 27. Albuminuria was measured by collection of fasting random urine specimen on arrival to the clinic, usually in the morning. The IMT was measured by a B-mode ultrasound, 10 MHz transducer. Each group was evaluated for body mass index (BMI), glycosylated hemoglobin (HbA1C), lipid profile, blood pressure. Results: Systolic blood pressure in the II-group was 143.3 ± 15.2mmHg and significantly higher (p < 0.01) than in the I-group (132.5 ± 18.1mmHg) and III-group (139.8 ± 18.9mmHg). No significant differences in age, smoking and kind of antihypertensive agent used were found between three groups. IMT level in the II-group was 1.28 ± 0.35 mm and significantly higher than in the I and III group (1.09 ± 0.28 mm; 1.19 ± 0.44 mm, respectively). There were no significant differences in HbA1C, lipid or serum creatinine between three groups Conclusions: The carotid IMT was significantly higher in the patients with microalbuminuria and so, the last one is associated with structural changes in arteries.