The Study Of The Correlation Factors Of Carotid Intima-Media Thickness(IMT)in Patients With Type 2 Diabetes Meltltus

Objective: To investigate the correlation factors of carotid intima-media thickness(IMT) in patients with type 2 diabetes meltltus(T2DM) and the influence of glucose-lowering drugs.Method : A total of 352 type 2 diabetic mellitus patients were concluded and divided into normal and abnormal groups according to IMT,body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), triglyceride(TG), total cholesterol(TC), high-density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C), fasting blood glucose(FBG), 2-hour postprandial plasma glucose(2hPG), fasting insulin(FINS), insulin resistance index (InHOMA-IR), urinary albumin excretion rate(UAER) and urinary albumin/creatinine(UAlb/Cr) was measured respectively, meanwhile, ages and course of disease were collected. Significance of differences among multiple IMT groups of means was evaluated by one way analysis of variance (ANOVA), and correlation analysis and multiple stepwise regression analysis were done between IMT and other factors. P < 0.05 was considered statistically significant. Simultaneously, patients who used only insulin or insulin combined with one type of hypoglycemic agents for more than 3 years were divided into 5 groups, we called them insulin treatment group,insulin combined insulin secretagogues treatment group,insulin combined biguanide treatment group,insulin combined glucosidase inhibitor treatment group and insulin combined euglycemic agent treatment group,compared their BMI,TG,LDL-C,HDL-C,SBP,DBP respectively before and after drug treatment. Meanwhile, we recorded the numbers of coronary heart disease respectively,and analyzed the changes of IMT,BMI,TG,LDL-C,HDL-C,SBP and DBP,to observe the influence of hypoglycemic agents.Result:There was a statistics significance between normal IMT group and abnormal group in age, course of disease, 2hPG, LDL-C, HDL-C, InHOMA-IR, UAER(P< 0.01 or P <0.05),respectively. There was positive correlation between IMT and age, course of disease, BMI, SBP, 2hPG, TG, TC, LDL-C, FINS, InHOMA-IR, UAER, UAlb/Cr(P< 0.01 or P <0.05), and IMT was negatively correlated with HDL-C(P< 0.01), and without correlation in DBP,FBG,HBA1C(P>0.05). The variance of equation of multiple linear regression was age, course of disease,2hPG,LDL-C,BMI,InHOMA-IR,UAER,UAlb/Cr and HDL-C. In the five different treatment groups ,the decrease of IMT was more significant in insulin combined biguanide treatment group and insulin combined euglycemic agent treatment group,compared with insulin treatment group,insulin combined insulin secretagogues treatment group and insulin combined glucosidase inhibitor treatment group ,(P<0.05).But there was no statistical significance between insulin combined biguanide treatment group and insulin combined euglycemic agent treatment group (P>0.05).we also observed that, there was no connection between insulin treatment group,insulin combined insulin secretagogues treatment group,insulin combined biguanide treatment group,insulin combined glucosidase inhibitor treatment group,insulin combined euglycemic agent group and coronary artery disease (p>0.05).Conclusions:Advanced age having long course of disease,obesity, high diastolic blood pressure, hyperglycemia after 2-hour postprandial plasma glucose, insulin resistance, abnormal urine protein could be important risk factors for atherosclerosis. We should avoid these dangerous factors and choose the applicable hypoglycemic agents.