High-frequency Ultrasound In Evaluation On Impact Of GFR To Carotid Intima-media Thickness And Remodeling Of Carotid Atherosclerosis Of Type2Diabetes Nephropathy Patients

Objective: To observe the impact of GFR on intima-media thickness (IMT) ofcarotid and remodeling of carotid atherosclerosis in type2diabetes nephropathy (DN)patients with high-frequency ultrasound.Methods: Patients with Type2DN were divided into three groups according tothe level of GFR, including34with GFR level more than or equal to90ml/min/1.73m2in group B,while39with GFR level more than or equal to60ml/min/1.73m2and lessthan90ml/min/1.73m2in group C,and the other25with GFR level less than60ml/min/1.73m2in group B. Meanwhile,50healthy subjects were enrolled in group Das normal controls. All Type2DN patients and healthy subjects were examined withhigh-frequency ultrasound. The IMT of carotid,total vessel area (TVA) and lumen area(LA) of the vessels in which atherosclerotic plaque could be found were measured,whilethe remodeling index (RI) and GFR were calculated.Results: The IMT of the trunk, bifurcation site of common carotid artery, theinternal carotid artery,the average IMT and the carotid artery plaque rate in group B,Cand D were higher than those in group A (P＜0.01),these in group C and D were higherthan those in group B (P＜0.05),these in group D were higher than those in group C (P＜0.05).The vessels involved rate of group B,C and D was higher than that of group A(all P＜0.01),it was higher of group D than that of group B and C (P＜0.05). Vessels’rate of more than two plaque of group D was higher than that of group A,B and C (P＜0.05).Negative correlation was observed between GFR and the average IMT(r=-0.33,P＜0.05).The remodeling rate of carotid atherosclerosis in group B,C and D was higherthan that in group A（P＜0.05）,it in group C and D was higher than that in group B（P＜0.05）,and it in group D was higher than in group C（P＜0.05）.There is an ascending trend of negative remodeling rate as GFR decreases,but significant difference was foundonly between group A and D（P＜0.05）.Vessels without remodeling is the main type ofgroup A,but positive remodeling is the main type of group B,C and D,while the positiveremodeling rate was higher than negative remodeling rate in all the groups.Conclusion: In diabetic nephropathy patients,GFR is correlated with carotidIMT,the vessel remodeling maybe influenced by GFR. High-frequency ultrasound is aconvenient and precise method in assessing the impact of GFR on carotidatherosclerosis and remodeling of carotid atherosclerosis in diabetic nephropathypatients.