[Subclinical arteriosclerosis in patients with newly diagnosed type 2 diabetes mellitus. Demonstration by high-resolution ultrasound measurements of intima-media thickness of the common carotid and femoral arteries].Dtsch Med Wochenschr 2000; 125(21):648-54DM
BACKGROUND AND OBJECTIVE
Type 2 diabetes mellitus is an important risk factor for the development of atherosclerosis. Early subclinical manifestation of atherosclerosis can be reliably recognized by measuring the thickness of the intima and media (IMT). The aim of this study was to examine vessel changes and the extent of possible risk factors in patients with newly diagnosed type 2 diabetes (interval since diagnosis < or = 1 year) and control persons without DM.
PATIENTS AND METHODS
Maximal IMT was measured by high resolution ultrasound of the common carotid (CCA) and femoral arteries (FA) in 51 type 2 diabetics and 18 controls. Various clinical and laboratory data (urinary excretion of albumin and protein, blood lipids) as well as amount of smoking, frequency of eating fruit and amount of sport activity were obtained in a standardized manner.
The patients' body-weight was markedly greater and blood pressure significantly higher than that of the controls. Hypertension was present in 43% of patients (control group 11%) microalbuminuria in 26%. Mean IMT of the CCA was 0.76 +/- 0.20 mm in the patients and 0.64 +/- 0.16 mm in the controls (p < 0.01). The IMT of the FA, however, was not significantly different in the two groups (patients: 0.80 + 0.30 mm, controls: 0.75 +/- 0.31 mm). The IMT of the CCA was correlated with the patients' age (r = 0.55; p < 0.001), with the level of total cholesterol (r = 0.39; p < 0.01), and with the presence of hypertension (r = 0.38; p < 0.01). Patients who daily eat fruit had a significantly lower IMT of the FA than those who did not eat fruit regularly (no such difference was found regarding the CCA). Linear multiple regression analysis indicated that these variables were factors that independently affected the IMD of the CAA and the FA.
An increase in subclinical atherosclerosis was demonstrated in type 2 diabetics already during the first year after diagnosis. The risk factors for the development of atherosclerosis in newly diagnosed diabetics exert a greater effect on the CCA than the FA. Regular eating of fruit seems to have a favourable effect on the progression of atherosclerosis of the FA.