Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus

gül, kamile; Guler, Serdar; AYDIN, Yusuf; Berker, Dilek; ÜNAL, MUSTAFA; ÜSTÜN, İhsan; BARAZİ, Ayşe Özden; EROL, Kutlu; DELİBAŞI, Tuncay

Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus

Kamile GÜL, (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara, Türkiye)

İhsan ÜSTÜN, (Erdemli Devlet Hastanesi, Endokrinoloji Kliniği, Mersin, Türkiye)

Yusuf AYDIN, (Ankara Numune Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara, Türkiye)

Dilek BERKER, (Ankara Numune Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara, Türkiye)

Kutlu EROL, (Department, of Psychiatry and Behavioral Sciences, Univercity of Miami Miller School of Medicine, Miami, Florida, USA)

Mustafa ÜNAL, (Afyon Devlet Hastanesi, Endokrinoloji Kliniği, Afyon, Türkiye)

Ayşe Özden BARAZİ, (Ankara Numune Eğitim ve Araştırma Hastanesi, Biyokimya Kliniği, Ankara, Türkiye)

Tuncay DELİBAŞI, (Ankara Numune Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara, Türkiye)

Serdar GÜLER (Ankara Numune Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara, Türkiye)

Anadolu Kardiyoloji Dergisi

3 1

Yıl: 2010 Cilt: 10 Sayı: 1 Sayfa Aralığı: 52 - 58 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus

Öz:

Amaç: Ateroskleroz tip 1 diyabetes mellituslu (DM) hastalarda mortalite ve morbiditenin en önemli nedenidir. Karotis intima-media kalınlığı (KIMK) aterosklerozisin dolayısıyla da makrovasküler hastalıkların erken bir bulgusu olarak bildirilmektedir. Bu çalışmadaki amacımız, tip 1 DM’li hastaların KIMK’ını ve mikrovasküler komplikasyonlarla ilişkisini (nefropati ve retinopati) değerlendirmektir. Yöntemler: Enine-kesitli olan bu çalışmaya, makrovasküler hastalığı olmayan 113 tip 1 DM’li hasta ardışık olarak ve yaş, cinsiyet, vücut kitle indeksi uyumlu 59 sağlıklı birey kontrol grubu olarak alındı. Diyabetik hastaların mikrovasküler komplikasyon taramaları yapıldı. Karotid arterlerin ultrasonografik değerlendirmesi yüksek rezolüsyonlu ultrasonografi ile yapıldı. İstatistiksel analizlerde Student’s t, Mann Whitney U, Ki-Kare, Kruskal Wallis testleri ve çok değişkenli doğrusal regresyon analizi kullanıldı. Bulgular: Tip 1 DM’li hastaların KIMK (0.67±0.11mm) kontrol grubundan (0.5±0.07 mm) anlamlı olarak yüksekti (p<0001). Mikrovasküler komplikasyonu (nefropati ve/veya retinopati) olan hastaların KIMK (0.70±0.11 mm)’ı olmayanlara (0.63±0.09 mm) göre anlamlı olarak artmıştı (p=0.001). Tip 1 DM’li hastalarda yapılan çok değişkenli regresyon analizinde artmış KIMK, proliferatif retinopatinin varlığı (beta=0.037, %95GA 0.010-0.065, p=0.008], makroalbuminuri (beta=0.043, %95GA 0.019-0.068, p=0.001), 24 saatlik idrarda albumin atılımı (beta=0.00003, %95GA 0.00001-0.00005, p=0.005) ve diyabet süresine (beta=0.002, %95GA (0.001-0.003), p=0.009) bağlı idi.Sonuç: Tip 1 diyabetik hastalarda artmış KIMK mikrovasküler komplikasyonlar ile ilişkilidir. Bu bulgu da diyabetik mikroanjiyopati ve makroanjiyopatinin birbirleri ile bağlantılı olduğunu göstermektedir. Bununla birlikte artmış KIMK’ın prognoz üzerine etkilerinin değerlendirilmesi için prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Tip 1 diyabetes mellituslu hastalarda karotis intima-media kalınlığı ve komplikasyonlarla ilişkisi

Öz:

Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student’s t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	gül k, ÜSTÜN İ, AYDIN Y, Berker D, EROL K, ÜNAL M, BARAZİ A, DELİBAŞI T, Guler S (2010). Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. , 52 - 58.
Chicago	gül kamile,ÜSTÜN İhsan,AYDIN Yusuf,Berker Dilek,EROL Kutlu,ÜNAL MUSTAFA,BARAZİ Ayşe Özden,DELİBAŞI Tuncay,Guler Serdar Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. (2010): 52 - 58.
MLA	gül kamile,ÜSTÜN İhsan,AYDIN Yusuf,Berker Dilek,EROL Kutlu,ÜNAL MUSTAFA,BARAZİ Ayşe Özden,DELİBAŞI Tuncay,Guler Serdar Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. , 2010, ss.52 - 58.
AMA	gül k,ÜSTÜN İ,AYDIN Y,Berker D,EROL K,ÜNAL M,BARAZİ A,DELİBAŞI T,Guler S Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. . 2010; 52 - 58.
Vancouver	gül k,ÜSTÜN İ,AYDIN Y,Berker D,EROL K,ÜNAL M,BARAZİ A,DELİBAŞI T,Guler S Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. . 2010; 52 - 58.
IEEE	gül k,ÜSTÜN İ,AYDIN Y,Berker D,EROL K,ÜNAL M,BARAZİ A,DELİBAŞI T,Guler S "Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus." , ss.52 - 58, 2010.
ISNAD	gül, kamile vd. "Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus". (2010), 52-58.

APA	gül k, ÜSTÜN İ, AYDIN Y, Berker D, EROL K, ÜNAL M, BARAZİ A, DELİBAŞI T, Guler S (2010). Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. Anadolu Kardiyoloji Dergisi, 10(1), 52 - 58.
Chicago	gül kamile,ÜSTÜN İhsan,AYDIN Yusuf,Berker Dilek,EROL Kutlu,ÜNAL MUSTAFA,BARAZİ Ayşe Özden,DELİBAŞI Tuncay,Guler Serdar Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. Anadolu Kardiyoloji Dergisi 10, no.1 (2010): 52 - 58.
MLA	gül kamile,ÜSTÜN İhsan,AYDIN Yusuf,Berker Dilek,EROL Kutlu,ÜNAL MUSTAFA,BARAZİ Ayşe Özden,DELİBAŞI Tuncay,Guler Serdar Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. Anadolu Kardiyoloji Dergisi, vol.10, no.1, 2010, ss.52 - 58.
AMA	gül k,ÜSTÜN İ,AYDIN Y,Berker D,EROL K,ÜNAL M,BARAZİ A,DELİBAŞI T,Guler S Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. Anadolu Kardiyoloji Dergisi. 2010; 10(1): 52 - 58.
Vancouver	gül k,ÜSTÜN İ,AYDIN Y,Berker D,EROL K,ÜNAL M,BARAZİ A,DELİBAŞI T,Guler S Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. Anadolu Kardiyoloji Dergisi. 2010; 10(1): 52 - 58.
IEEE	gül k,ÜSTÜN İ,AYDIN Y,Berker D,EROL K,ÜNAL M,BARAZİ A,DELİBAŞI T,Guler S "Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus." Anadolu Kardiyoloji Dergisi, 10, ss.52 - 58, 2010.
ISNAD	gül, kamile vd. "Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus". Anadolu Kardiyoloji Dergisi 10/1 (2010), 52-58.