한국 성인에서 경동맥 내중막 두께의 기준치와 제2형 당뇨병에서 이를 이용한 대혈관 합병증의 상대위험도

Abstract

BACKGROUND: The reference values of the carotid mean intima-medial thickness (IMT), in subjects without diabetes or macrovascular diseases, were estimated, which were used to establish the relative risks of macrovascular diseases in type 2 diabetic subjects. METHODS: High resolution B-mode ultrasonography was performed in 1229 nondiabetic subjects, without ischemic heart disease, cerebral infarction or peripheral vascular disease, and in 830 type 2 diabetic subjects. The nondiabetic subjects were participating in medical checkups at the Health Promotion Center. The height, weight, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol and fasting insulin level were measured in all subjects. RESULTS: The nondiabetic subjects, without ischemic heart disease, cerebral infarction or peripheral arterial obstructive diseases, were classified by age (31~40, 41~50, 51~60, 61~70 and >70 years) and sex. There were significant differences between the diabetic and nondiabetic subjects in relation to the age groups, but no significant difference was found between the sexes. Independent risk factors associated with the carotid mean IMT in the nondiabetic subjects were age, systolic blood pressure and body mass index, and those in the diabetic subjects were age, duration of diabetes and a low density lipoprotein-cholesterol level. The relative risks of ischemic heart disease, cerebral infarction and peripheral vascular disease, due to the presence of an increased IMT, were 2.34 (CI; 1.32~4.14), 2.95 (CI; 1.57~5.54) and 3.64 (CI; 1.79~7.40) in the diabetic subjects. CONCLUSION: It was concluded that the reference values of the IMT, as classified by age, in the subjects without diabetes or macrovascular diseases, favorably reflected the risks of macrovascular diseases in the type 2 diabetic subjects