Kronik Böbrek Hastalığı Olan Tip 2 Diyabetli Hastalarda Aortik Yayılım Hızı ile Subklinik Aterosklerozun Değerlendirilmesi

Abstract

Giriş: Diabetes mellitus (DM) ve kronik böbrek hastalığı (KBH) aterosklerozu hızlandırmaktadır. Klinik sonuçları iyileştirmek için, aterosklerozu değerlendiren ve izleyen invaziv olmayan görüntüleme yöntemleri geliştirilmektedir. Son zamanlarda, inen torasik aortun renkli M-mod yayılım hızının [aortik yayılım hızı (AYH)] koroner ve karotisaterosklerozu ile ilişkili olduğu gösterilmiştir.

Hastalar ve Yöntem: Çalışma popülasyonu KBH olan tip 2 diyabetli 90 hasta (grup 1) ve yaş ve cinsiyet benzer, normal böbrek fonksiyonlarına sahip tip 2 diyabetli 40 hastadan (grup 2) oluşmaktaydı. Karotis intima-media kalınlığı (KİMK) ve AYH ölçüldü. Bilinen koroner kalp hastalığı veya son dönem böbrek yetmezliği olan hastalar çalışmaya dahil edilmedi.

Bulgular: Grup 2 ile karşılaştırıldığında, grup 1 hastalar daha düşük AYH düzeylerine (grup 1= 29.85 ± 3.95 cm/sn ve grup 2= 41.05 ± 3.34 cm/s, p< 0.001) ve daha yüksek KİMK düzeylerine (grup 1= 1.06 ± 0.11 mm ve grup 2= 0.78 ± 0.10 mm, p< 0.001) sahipti. AYH ve KİMK arasında anlamlı korelasyon mevcuttu (r= -0.669, p< 0.001).

Sonuç: KBH olan diyabetli hastalar, normal böbrek fonksiyonlu diyabetli hastalara göre daha belirgin AYH ve KIMK değerleri ile belirlenen daha fazla subklinik ateroskleroza sahiptir. Bu basit metodlar, aterosklerozun progresyonunun primer önlenmesi için hasta seçimini geliştirebilir.

Keywords

• Aortik yayılım hızı,karotis intima-media kalınlığı,tip 2 diabetes mellitus,kronik böbrek hastalığı,ateroskleroz

Assessment of Subclinical Atherosclerosis with Aortic Velocity Propagation in Patients with Type 2 Diabetes and Chronic Kidney Disease

Abstract

Introduction: Diabetes mellitus (DM) and chronic kidney disease (CKD) accelerate the process of atherosclerosis. To improve clinical outcomes, non-invasive imaging modalities have been proposed to measure and monitor atherosclerosis. Recently, colour M-mode-derived propagation velocity of the descending thoracic aorta [aortic velocity propagation (AVP)] has been shown to be associated with coronary and carotid atherosclerosis.

Patients and Methods: The study population included 90 patients with type 2 diabetes who had CKD (Group 1) and 40 age- and sex-matched patients with type 2 diabetes who had a normal renal function (Group 2). Carotid intima-media thickness (CIMT) and AVP were measured. Patients with known coronary heart disease or end-stage renal disease were excluded.

Results: Compared with Group 1, patients in Group 2 had significantly lower AVP (Group 1=  29.85 ± 3.95 cm/s and Group 2= 41.05 ± 3.34 cm/s, p< 0.001) and higher CIMT (Group 1= 1.06 ± 0.11 mm and Group 2= 0.78 ± 0.10 mm, p< 0.001). There were significant correlations between AVP and CIMT (r= -0.669, p< 0.001).

Conclusion: Patients with diabetes who have CKD exhibit more subclinical atherosclerosis, which is determined by more prominent AVP and CMIT, than patients with diabetes who have a normal renal function. These simple methods might improve patient selection for the prevention of primary atherosclerotic progression.

Keywords

• Aortic velocity propagation,carotid intima-media thickness,type 2 diabetes,chronic kidney disease,atherosclerosis

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