Àá½Ã¸¸ ±â´Ù·Á ÁÖ¼¼¿ä. ·ÎµùÁßÀÔ´Ï´Ù.

Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes

´ëÇѳ»ºÐºñÇÐȸÁö 2013³â 28±Ç 4È£ p.309 ~ 319
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

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¸

KCI
KoreaMed
KAMS