미세혈관 합병증이 없는 노인 당뇨병 환자에서 무증상의 죽상 경화증의 위험요인에 대한 분석

Abstract

Background: Diabetes Mellitus is a major independent risk factor for atherosclerosis. We have no information on the prevalence of asymptomatic atherosclerosis in diabetic patients before the onset of microvascular diseases. The aims of this study was to evaluate risk factors for the atherosclerosis in elderly type 2 diabetic patients without the microvascular diseases.

Methods: We evaluated atherosclerotic change of carotid arteries in 60 elderly Korean type 2 diabetic patients who had neither atherosclerotic vascular diseases nor diabetic microvascular complications.When atherosclerotic change was defined as the mean intima-media thickness (IMT) of ＞1.0 mm and/or the presence of plaque lesion, 28.3% of patients had atherosclerosis of the carotid arteries.

Results: Risk factors for the carotid atherosclerosis were age, low-density lipoprotein (LDL)-cholesterol, hypertension, and diabetes treatment. Age and LDL-cholesterol were associated with mean IMT. Fasting plasma glucose, glycosylated hemoglobin (HbA1c), and known diabetes duration remained unassociated with any parameters of asymptomatic atherosclerosis of the carotid arteries.

Conclusion: Glycemic control is unrelated with asymptomatic atherosclerosis in elderly type 2 diabetic patients without diabetic microvascular complications. Conventional risk factors and diabetes treatment are independently associated with atherosclerosis of the carotid arteries in these patients.