Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes
Á¤ÂùÈñ, ¹é¾Ö¸°, ±è±ÔÁø, ±èº¸¿¬, ±èöÈñ, °¼º±¸, ¸ñÁö¿À,
¼Ò¼Ó »ó¼¼Á¤º¸
Á¤ÂùÈñ ( Jung Chan-Hee )
Soonchunhyang University College of Medicine Department of Internal Medicine
¹é¾Ö¸° ( Baek Ae-Rin )
Soonchunhyang University College of Medicine Department of Internal Medicine
±è±ÔÁø ( Kim Kyu-Jin )
Soonchunhyang University College of Medicine Department of Internal Medicine
±èº¸¿¬ ( Kim Bo-Yeon )
Soonchunhyang University College of Medicine Department of Internal Medicine
±èöÈñ ( Kim Chul-Hee )
Soonchunhyang University College of Medicine Department of Internal Medicine
°¼º±¸ ( Kang Sung-Koo )
Soonchunhyang University College of Medicine Department of Internal Medicine
¸ñÁö¿À ( Mok Ji-Oh )
Soonchunhyang University College of Medicine Department of Internal Medicine
KMID : 0356620130280040309
Abstract
Background: It is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM.
Methods: A total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) ¡Ã or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing¡¯s protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points ¡Ã2. Diabetic microangiopathies were assessed.
Results: Patients with CAN comprised 77% of the group with mean CIMT ¡Ã1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT ¡Ã1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with ¡Ã2 carotid plaques, while they were 23% of the group with ¡Â1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio [OR] of 8.6 (95% confidence interval [CI], 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening.
Conclusion: These results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.
Å°¿öµå
Cardiac autonomic neuropathy; Diabetic angiopathies; Carotid intima-media thickness; Carotid plaque; Diabetes mellitus; type 2
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸