Sztywność tętnic szyjnych u pacjentów z cukrzycą typu 2

Abstract

Background: Functional carotid arterial changes expressed by arterial stiffness indices represent subclinical organ damage in subjects with type 2 diabetes mellitus (T2D). There are still controversies to what extent diabetes per se influences arterial stiffness and what is the contribution of other atherosclerotic risk factors in arterial stiffness pathophysiology. The aim of the study was to assess carotid arterial stiffness in patients with uncomplicated T2D. We examined the relationship of classical cardiovascular risk factors and haemoglobin A1 and arterial stiffness indices in diabetes. Methods: The study group consisted of 168 subjects: 84 subjects with T2D (34 M, 50 F, mean age 55,8±7,9) and 84 healthy patients (60 M, 24 F, mean age 54,3±7,0). From carotid arteries ultrasound - high-resolution echo-tracking (eT) arterial stiffness parameters were evaluated: β, Ep, AC, AI, PWV-β. Results: β, Ep, AI, PWV- β were higher in patients with T2D in the comparison with control group. In the group of T2D in stepwise multivariate analysis of arterial stiffness indices the following models were achieved with only significant variables β=1.8+0.096xPP+0.07xage; R2=0.166, Ep=16.7+1.852xPP; R2=0.286, AC=1.9–0.005xSBP–0.007xHR+0.14xsmoking cigarettes; R2=0.165, AI=18.0–0.80xBMI+0.40xage; R2=0.147. PWV-β=- 0.4+0.77xSBP–0.72xMAP–0.50xPP+0.03xHR; R2=0.235 Conclusions: T2D constitutes the strong independent determinant of arterial stiffness. In patients with T2D the independent determinants of arterial stiffness parameters were age, SBP, MBP, PP, HR, BMI and smoking cigarettes. Not only glycemic control but also a multifactorial anti-risk strategy might play an important role in the prevention of the development of vascular stiffness and subclinical target organ damage in diabetes