Tip 2 Diyabette Koroner Arter Hastalığı Varlığı Serebrovasküler Hastalık İçin Bir Risk Faktörü müdür?

Year 2018, , 173 - 176, 26.09.2018

Abdulhalim Şenyiğit

https://doi.org/10.21673/anadoluklin.403862

Abstract

Amaç: Bu çalışmada, koroner arter hastalığı olan tip 2 diyabetik hastalar ile nefropatisi olan tip
2 diyabetik hastaları ana karotis intima–media kalınlığı açısından karşılaştırmak amaçlanmıştır.

Gereç ve Yöntemler: Çalışmaya koroner arter hastalığı olan tip 2 diyabetik hastalar (n=36) ve koroner
arter hastalığı olmayan, nefropati ile komplike tip 2 diyabetik hastalar (n=31) alındı. Sağ ve
sol ana karotis arter intima–media kalınlığı B-mod ultrasonografi ile değerlendirildi. Hastalarda
kardiyovasküler hastalık açısından diğer geleneksel risk faktörleri de değerlendirildi.

Bulgular: Koroner arter hastalığının eşlik ettiği diyabet hastalarında hem sağ hem de sol ana
karotis arter intima–media kalınlığı, sadece nefropatinin eşlik ettiği diyabet hastalarına göre anlamlı
derecede fazla bulundu (sağ ana karotis için 0,99 mm’ye 0,82 mm, sol ana karotis için 1,07
mm’ye 0,92 mm; her ikisi için de p<0,05). Hastalarda aterosklerotik diğer kardiyovasküler risk
faktörleri (LDL-kolesterol, HDL-kolesterol, sistolik ve diyastolik kan kan basıncı, diyabet yaşı) iki
grup arasında benzerdi (hepsi için p>0,05).

Tartışma ve Sonuç: Koroner arter hastalığı varlığı tip 2 diyabette eşlik eden serebrovasküler
hastalık için önemli bir göstergedir

Keywords

Tip 2 diyabet, koroner arter hastalığı, karotis intima–media kalınlığı, serebrovasküler hastalık

Coronary Artery Disease in case of an already diagnosed Type 2 Diabetes, presents as an important risk factor for cerebrovascular disease.

Abstract

Aim: This study aims to compare type 2 diabetic patients with coronary artery disease and type
2 diabetic patients with nephropathy in terms of common carotid artery intima–media thickness.

Materials and Methods: The study included type 2 diabetics with coronary artery disease
(n=36) and type 2 diabetics without coronary artery disease but with complicating nephropathy
(n=31). The right and left common carotid arteries were evaluated in terms of intima–media
thickness by using B-mode ultrasonography. Other traditional risk factors for cardiovascular
disease were also evaluated.

Results: Both right and left common carotid artery intima–media thicknesses were found to
be significantly greater for the diabetics with concomitant coronary artery disease than for the
diabetics with concomitant nephropathy only (0.99 mm vs 0.82 mm for the right and 1.07 mm
vs. 0.92 mm for the left common carotid artery; p<0.05 for both). Other atherosclerotic cardiovascular
risk factors (LDL-cholesterol, HDL-cholesterol, systolic and diastolic blood pressure,
diabetic age) were similar for both groups (p>0.05 for all).

Discussion and Conclusion: Presence of coronary artery disease is an important indicator for
concomitant cerebrovascular disease in type 2 diabetics

Keywords

Type 2 diabetes, carotid artery intima-media thickness, coronary artery disease, cerebrovascular disease

References

• 1-Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44(Suppl. 2):S14– S21.2- Stratton LM, Adler AJ, Neil HA et al (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321:405–4123- DeFronzo RA. Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009;58: 773–795 4- Mazzone T. Reducing cardiovascular disease in patients with diabetes mellitus. Curr Opin Cardiol. 2005;20:245-2495- DeFronzo RA. Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009. Diabetologia 2010;53: 1270–12876- Hodis HN, Mack WJ, LeBree L. et al. The role of carotid arterial intima-media thickness in predicting clinical coronary events. Ann Intern Med. 1998;128:262-2697-Sarnak MJ, Levey AS, Schoolwerth AC, et al; American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation. 2003;108(17):2154–2169.8- Dinneen SF, Gerstein HC. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus. A systematic overview of the literature. Arch Intern Med. 1997;157(13): 1413–1418.9- Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham Study. JAMA. 1979;241:2035–2038.10- Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals: does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA. 1990;263:2893–2898.11- Wagenknecht LE, D’Agostino RB, Haffner S, Savage P, Rewers M. Impaired glucose tolerance, type 2 diabetes, and carotid wall thickness: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 1998;21: 1812–1818.12- Yamasaki Y, Kodama M, Nishizawa H, Sakamoto K, Matsuhisa M, Kajimoto Y, Kosugi K, Shimizu Y, Kawamori R, Hori M. Carotid intima-media thickness in Japanese type 2 diabetic subjects: predictors of progression and relationship with incident coronary heart disease. Diabetes Care. 2000;23:1310 –1315.13- Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–130514- de Zeeuw D, Remuzzi G, Parving HH, et al. Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation. 2004;110(8):921–92715- Yokoyama H, Katakami N, Yamasaki Y. Recent advances of intervention to inhibit progression of carotid intima-media thickness in patients with type 2 diabetes mellitus. Stroke. 2006;37:2420-2427.16- Ludwig M, Kraft K, Rucker W, Huther AM. Diagnosis of very early arteriosclerotic vascular wall changes using duplex sonography. Klin Wochenschr. 1989;67:442– 446.17- Handa N, Matsumoto M, Maeda H, Hougaku H, Ogawa S, Fukunaga R, Yoneda S, Kimura K, Kamada T. Ultrasonic evaluation of early carotid atherosclerosis. Stroke. 1990;21:1567–1572.