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1 型糖尿病患者颈动脉内膜中层厚度与左心室质量的关系(来自糖尿病干预与并发症流行病学研究 [EDIC])。

Relation between carotid intima-media thickness and left ventricular mass in type 1 diabetes mellitus (from the Epidemiology of Diabetes Interventions and Complications [EDIC] Study).

机构信息

Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

出版信息

Am J Cardiol. 2012 Nov 15;110(10):1534-40. doi: 10.1016/j.amjcard.2012.07.014. Epub 2012 Aug 9.

Abstract

Type 1 diabetes mellitus (DM) is associated with early atherosclerosis and increased cardiovascular mortality. The relation between carotid intima-media thickness (cIMT), a marker of subclinical atherosclerosis, and left ventricular (LV) mass, an independent predictor of cardiovascular morbidity, has not been previously studied in type 1 DM. The Epidemiology of Diabetes Interventions and Complications (EDIC) study is a multicenter observational study designed to follow up the Diabetes Control and Complications Trial (DCCT) cohort. LV mass was measured with cardiac magnetic resonance imaging at EDIC year 15 and common cIMT was assessed using B-mode ultrasound at EDIC year 12. Multivariable linear regression models were used to assess the relation between cIMT at year 12 and LV mass at year 15. In total 889 participants had cardiac magnetic resonance imaging and cIMT measurements available for these analyses. At EDIC year 15, mean age of the participants was 49 ± 7 years, mean DM duration was 28 ± 5 years, and 52% were men. Spearman correlation coefficient (r) between LV mass and cIMT was 0.33 (p <0.0001). After adjusting for basic covariates (machine, reader, age, and gender), a significant association between LV mass and cIMT (estimate 2.0 g/m(2) per 0.1-mm cIMT increment, p <0.0001) was observed. This association was decreased by the addition of systolic blood pressure, in particular 1.15 g/m(2) per 0.1-mm cIMT increment (p <0.0001), and to a lesser extent other cardiovascular disease risk factors. Furthermore, the relation observed between LV mass and cIMT was stronger in patients with shorter duration of DM. In conclusion, cIMT was an independent predictor of larger LV mass in a well-characterized population with type 1 DM.

摘要

1 型糖尿病(DM)与早期动脉粥样硬化和心血管死亡率增加有关。颈动脉内膜中层厚度(cIMT)作为亚临床动脉粥样硬化的标志物,与左心室(LV)质量(心血管发病率的独立预测因子)之间的关系尚未在 1 型 DM 中进行过研究。糖尿病控制和并发症试验(DCCT)的多中心观察性研究,EDIC 研究设计用于随访该队列。在 EDIC 研究第 15 年,使用心脏磁共振成像测量 LV 质量,在 EDIC 研究第 12 年使用 B 型超声评估常见 cIMT。使用多变量线性回归模型评估第 12 年 cIMT 与第 15 年 LV 质量之间的关系。共有 889 名参与者接受了心脏磁共振成像和 cIMT 测量,可用于这些分析。在 EDIC 第 15 年,参与者的平均年龄为 49 ± 7 岁,DM 病程的平均时间为 28 ± 5 年,52%为男性。LV 质量与 cIMT 之间的斯皮尔曼相关系数(r)为 0.33(p <0.0001)。在调整了基本协变量(机器、读者、年龄和性别)后,LV 质量与 cIMT 之间存在显著相关性(估计每 0.1-mm cIMT 增加 2.0 g/m2,p <0.0001)。这种相关性在加入收缩压后降低,尤其是每 0.1-mm cIMT 增加 1.15 g/m2(p <0.0001),在一定程度上降低了其他心血管疾病危险因素。此外,在 DM 病程较短的患者中,LV 质量与 cIMT 之间的关系更强。总之,在 1 型 DM 患者中,cIMT 是 LV 质量较大的独立预测因子。

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本文引用的文献

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Myocardial structure, function, and scar in patients with type 1 diabetes mellitus.
Circulation. 2011 Oct 18;124(16):1737-46. doi: 10.1161/CIRCULATIONAHA.111.022327. Epub 2011 Sep 26.
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Relation of common carotid intima-media thickness with left ventricular mass caused by shared risk factors for hypertrophy.
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