제2형 당뇨병에서 관상동맥 질환 유무에 따른 경동맥 내중막 두께 측정의 한계
The Limitation in Measurement of Carotid Intima Media Thickness in Type 2 Diabetics with or without Coronary Artery Disease
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: The measurement of carotid intima-media thickness (IMT) is useful for detection of early atherosclerotic disease. But, IMT are influenced by various factors including hypertension, age, diabetes, etc. We tried to estimate the correlation between carotid IMT and coronary artery disease in diabetics. Methods: The B-mode ultrasonography and coronary angiography was perfomed in 50 as type 2 diabetes and 226 as nondiabetes. Carotid IMT was measured at around carotid bulb. Coronary artery lesions was evaluated based on quantitative coronary analysis (QCA) from coronary angiogram. Results: Type 2 diabetic group (mean age 64.5±8.9 years old) included 21 patients without coronary artery disease and 29 patients with coronary artery disease. Non-diabetic group (mean age 61.0±10.1) included 138 patients without coronary artery disease and 88 patients with coronary artery disease. In type 2 diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was similar to that of subjects without coronary disease (mean Rt. IMT,1.26±0.62 mm vs. 1.03±0.29 mm, respectively, p=0.11, mean Lt IMT, 1.30±0.70 mm vs. 1.17±0.43 mm, respectively, p=0.46). But in non-diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was more than that of subjects without coronary disease, and it is statistically significant (mean Rt. IMT, 1.09± 0.32 mm vs. 0.96±0.25 mm, respectively, p=0.01, mean Lt IMT, 1.19±0.47 mm vs. 1.01±0.32 mm, respectively, p=0.01). Conclusion: This study shows weak correlation power between carotid IMT and coronary artery diseases in diabetics, contrast to non-diabetes.
Abstract
Background: The measurement of carotid intima-media thickness (IMT) is useful for detection of early atherosclerotic disease. But, IMT are influenced by various factors including hypertension, age, diabetes, etc. We tried to estimate the correlation between carotid IMT and coronary artery disease in diabetics. Methods: The B-mode ultrasonography and coronary angiography was perfomed in 50 as type 2 diabetes and 226 as nondiabetes. Carotid IMT was measured at around carotid bulb. Coronary artery lesions was evaluated based on quantitative coronary analysis (QCA) from coronary angiogram. Results: Type 2 diabetic group (mean age 64.5±8.9 years old) included 21 patients without coronary artery disease and 29 patients with coronary artery disease. Non-diabetic group (mean age 61.0±10.1) included 138 patients without coronary artery disease and 88 patients with coronary artery disease. In type 2 diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was similar to that of subjects without coronary disease (mean Rt. IMT,1.26±0.62 mm vs. 1.03±0.29 mm, respectively, p=0.11, mean Lt IMT, 1.30±0.70 mm vs. 1.17±0.43 mm, respectively, p=0.46). But in non-diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was more than that of subjects without coronary disease, and it is statistically significant (mean Rt. IMT, 1.09± 0.32 mm vs. 0.96±0.25 mm, respectively, p=0.01, mean Lt IMT, 1.19±0.47 mm vs. 1.01±0.32 mm, respectively, p=0.01). Conclusion: This study shows weak correlation power between carotid IMT and coronary artery diseases in diabetics, contrast to non-diabetes.
참고문헌 (31)
- Ahn JC, "Association of intima-media thickness of common carotid artery, coronary artery atherosclerosis and atherosclerotic risk factors", J Kor Soc Echo, 4, pp.130~137 (1996)
- Park JH, "Carotid artery intima-media thickness in patients with hypertension with left ventricular hypertrophy", J Kor Soc Echo, 11, pp.94~101 (2003)
- 정진원, "동맥경화의 진단방법으로 경동맥 내막-중막 두께의 의의", Journal of Cardiovascular Ultrasound, 10(2), pp.8~12 (2002), 한국심초음파학회
- Chambless LE, "Carotid wall thickness is predictive of incident clinical stroke", Am J Epidemiol, 151, pp.478~487 (2000)
- Baldassarre D, "Carotid artery intima-media thickness measued by ultrasonography in normal clinical practice correlateds well with atherosclerosis risk factor", Stroke, 31, pp.2426~2430 (2000)
- Sulivaln DR, "A new method of scoring coronary angiogram to reflect extent of coronary atherosclerosis and improve correlation with major risk factors", Am Heart J, 119, pp.1262~1266 (1990)
- Wofford JL, "Relation of extent of extracranial carotid atherosclerosis as measured by B-mode ultrasound to the extent of coronary atheroslclerosis", Arterioscler Thromb, 11, pp.1786~1794 (1991)
- Salonen R, "Progression of carotid atherosclerosis and its determinants: a population-based ultrasonographic study", Atherosclerosis, 81, pp.33~40 (1990)
- Handa N, "Ultrasonic evaluation early carotid atherosclerosis", Stroke, 21, pp.1567~1572 (1990)
- Park BH, "Relation of carotid artery intima-media thicjness and atherosclerosis plaque with the extent of coronary artery stenosis", J Kor Soc Echo, 8, pp.45~53 (2000)
- Niskanen L, "Carotid artery intima-media thickness in elderly patients with NIDDM and in nondiabetic subjects", Stroke, 27, pp.1986~1992 (1996)
- Park TS, "Relationships between the intimal-medial thickness of carotid artery measured by high resolution B-mode ultrasound imaging and the atherosclerotic risk factors in NIDDM patients", Korean Diabetes J, 20, pp.145~152 (1996)
- Lee HC, "Associations of carotid intinmamedia thickness measured by high resolution B-mode ultrasonography and atherosclerotic risk factors in NIDDM patients", Korean Diabetes J, 23, pp.234~242 (1999)
- Glagov S, "Compensatory enlargement of human atherosclerotic coronary arteries", N Engl J Med, 316, pp.1371~1375 (1987)
- Cho YL, "Reference values of carotid artery intima-media thickness and association with atherosclerotic risk factors in healthy subjects in Korea", Kor J Med, 64, pp.275~284 (2003)
- Maylene R, "Coronary artery disease in patients with cerebrovascular disease: A prospective study", Ann Neurol, 16, pp.50~53 (1984)
- Rokey R, "Coroanry artery disease in patients with cerebrovascular disease: A prospective study", Ann Neurol, 16, pp.50~53 (1984)
- Di pasquale C, "Cerebral ischemia and asymptomatic coronary artery disease: A prospective study of 83 patients", Stroke, 17, pp.1098~1101 (1986)
- Hertzer NR, "Coronary angiography in 506 patients with extracranial cerebrovascular disease", Arch Intern Med, 145, pp.849~852 (1985)
- 안유배, "췌도이식", Diabetes and Metabolism Journal, 28(1), pp.1~8 (2004), 대한당뇨병학회
- Kim SJ, "The change in carotid intima-media thickness in prehypertensive adults", Kor J Med, 70, pp.165~172 (2006)
- Ford CS, "The role of plasma lipids in carotid bifurcation atherosclerosis", Ann Neurol, 17, pp.301~303 (1985)
- Jerome G, "Evidence for in vivo carotid and femoral wall thickening in human hypertension", Hypertension, 22, pp.111~118 (1993)
- Pujia A, "Common carotid arterial wall thickness in MIDDM subjects", Diabetes Care, 17, pp.1330~1336 (1994)
- Bonora E, "Bruneck study. Carotid atherosclerosis and coronary artery heart diseas in the metabolic syndrome: prospective data from the Bruneck study", Diabetes Care, 26, pp.1251~1257 (2003)
- Pyrola K, "Diabetes and atherosclerosis: an epidemiologic view", Diabetes Metab Rev, 3, pp.463~524 (1987)
- Ross R, "The pathogenesis of atherosclerosis:a perspective for the 1990s", Nature, 362, pp.801~809 (1993)
- Mudrikova T, "Carotid intima-media thickness in relation to macrovascular disease in patients with type 2 diabetes mellitus", Wien Klin Wochenschr, 27, pp.887~891 (2000)
- Leinonen ES, "Taskinen MR. Low-grade inflammation, endotherial activation and carotid intimamedia thickness in type 2 diabetes", J Intern Med, 256, pp.119~127 (2004)
- Kim HJ, "Normative data of intima-medial thickness in Korean adults and the estimation of the relative risk of macrovascular diseases using this data in type 2 diabetic subjects", Korean Diabetes J, 27, pp.1~10. (2003)
- Ahn YB, "Relationship between intimal-medial thickness (IMT) of the carotid artery and atherosclerotic risk factors in patients with type 2 diabets mellitus", Korean Diabetes J, 25, pp.142~151 (2001)
