Combined Atherosclerotic Lesions in Patients with Type 2 Diabetes Mellitus

L.V. Khimion, M.O. Rybytska

Abstract


Introduction. Significant prevalence of atherosclerosis and its complications in patients with type 2 diabetes mellitus (DM) determines the need for further investigations of existing risk factors. Objective. To determine the effect of various risk factors on the development of atherosclerotic lesions in patients with type 2 DM. Materials and methods. The average levels of systolic blood pressure (SBP), HbA1c, high sensitivity C-reactive protein (hsCRP), uric acid (UA), low density lipoprotein cholesterol (LDL–C) in the blood serum and the score by the anxiety and depression scale (HADRS) compared to the evaluation of ultrasound data of atherosclerotic lesion of the carotid arteries (intima-media thickness ≥ 0.9 mm or the presence of atherosclerotic plaques) and lower limb arteries (ankle-brachial index ≤ 0.9) were analyzed in 122 patients with type 2 DM (66 women, 56 men, mean age — 55.0 (49.8–62.0) years) during 5-year follow-up. Statistical analysis was performed using IBM SPSS Statistics 20. Results. During the study, patients were divided into 3 groups: group 1 — 48 people with atherosclerotic lesions of the carotid arteries and lower extremities, group 2 — 47 individuals with atherosclerosis of the carotid arteries, group 3 — 27 people with no signs of atherosclerotic lesion. It was found that in group 1 patients, the average levels of SBP (141.7 (132.1–152.9) mmHg), HbA1c (9.2 (8.2–9.9) %), hsCRP (5.8 (4.2–6.9) mg/L), UA (358.1 (302.4–396.1) μmol/L), LDL–C (4.1 (3.6–5.2) mmol/L), a score by HADRS (16.0 (9.0–18.8) points) were significantly higher compared to that of in group 3 (SBP — 136.7 (128.3–143.3) mmHg, HbA1c — 7.7 (7.0–8.4) %, hsCRP — 2.7 (1.1–3.3) mg/L, UA — 276.8 (227.0–316.0) μmol/L, LDL–C — 3.3 (3.0–4.0) mmol/L, a score by HADRS (8.0 (7.0–10.0) points) (p < 0.05). The average levels of HbA1c and hsCRP in group 1 patients were significantly higher compared with that of in group 2 (HbA1c — 8.7 (7.6–9.3) %, hsCRP — 4.2 (3.0–5.3) mg/L) (p < 0.05). Conclusion. In patients with type 2 DM with higher average levels of SBP, hsCRP, HbA1c, UA, LDL–C and anxiety-depressive disorders, the disease is associated with more frequent occurrence of atherosclerotic lesions, including combined lesions of arteries of different systems.

Keywords


type 2 diabetes mellitus; atherosclerosis of the carotid arteries; atherosclerosis of the lower limb arteries; cardiovascular risk factors.

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DOI: https://doi.org/10.22141/2224-0721.3.75.2016.76648

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