Diabetes Monit 2000;1(1):52-62.
제2형 당뇨병 환자에서 고혈압 유무에 따른 경동맥 죽상경화증 및 죽상경화증 위험인자들의 비교
박병현, 정진원, 조정구
Comparison of Carotid Artery Atherosclerosis and Atherosclerotic Risk Factors Between Type 2 Diabetes with Hypertension and without Hypertension
Byoung Hyun Park, Jin Won Jeong, Chung Gu Cho
Atherosclerosis is importantly associated with cardiovascular morbidity and mortality in type 2 diabetes mellitus. It has been reported that intima-media thickness (IMT) of common carotid artery (CCA) measured by ultrasound B-mode scan is capable of quantitatively evaluating atherosclerotic changes in a safe and reproducible way. However, little information currently exists on the difference of carotid atherosclerosis and atherosclerotic risk factors between type 2 diabetes with hypertension and type 2 diabetes without hypertension. Thus, current study was undertaken to investigate the association between hypertension and IMT of CCA, measured by ultrasound B-mode scan, in type 2 diabetes and to find the difference of atherosclerotic risk factors and the prevalence of macrovascular complicotion between type 2 diabetes with hypertension and type 2 diabetes without hypertension. Method: High resolution B-mode ultrasonography was performed in 21 type 2 diabetes without hypertension and 20 type 2 diabetes with hypertension to determine the correlation between hypertension and degree of carotid artery atherosclerosis by measurement of common carotid intima-media thickness (IMT) and carotid atherosclerotic plaques, Concurrently serum total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, lipoprotein (a), HbA1c, C-peptide levels and body mass index (BMI) were measured and history of hypertension, smoking and duration of diabetes were investigated. Presence of macrovascular complications such as cerebral infarction. angina pectoris, myocordial infarction and peripheral artery occlusion were examined by medical recording during the last 6 months. Results: 1) Common carotid artery IMT values for type 2 diabetes with hypertension (1.01±0.25 mm, n-20) were significantly greater than type 2 diabetes without hypertension (0.85±0.25 mm, n=21). But, weak correlation was existed between hypertension and common carotid IMT (r=0.31, p=0.049), 2) Presence of carotid artery atherosclerotic plaque was more common in hypertensive diabetes than normotensive diabetes (18/20; 90% vs 11/21; 52A%, p=0.007). 3) Most common involving site of atherosclerotic plaque was carotid bulb and it was not different between two groups. 4) Macrovascular complication was more common in hypertensive diabetes group than normotensive diabetes group (ll/20; 55% vs 5/21; 24%, p=0.042). 5) Serum triglyceride levels for hypertensive type 2 diabetes group were significantly greater than normotensive type 2 diabetes group (2.31±61.60 mmol/L, vs lAS+0.76 mmol/L; p=0.039). 6) Age, sex, duration of diabetes, smoking, BMI, HbA1c, C-peptide, total cholesterol, HDL cholesterol, LDL cholesterol, and lipoprotein (a) were not different in two groups, Conclusion: There was weak correlation between hypertension and carotid intima-media thickness in type 2 diabetes. Type 2 dlabetes with hypertension were greater carotid IMT, more presence and extent of atherosclerotic plaque, higher level of serum trlglyceride, and higher macrovascular complication than type 2 diabetes without hypertension.
Key Words: Type 2 diabetes, Hypertension, Intlma-media thickness (IMT), Atherosclerotic risk factors
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