الفهرس | Only 14 pages are availabe for public view |
Abstract Diabetes is a major risk factor for morbidity and mortality from cardiovascular disease. Non-insulin dependent diabetes mell itus is frequently associated with premature atherosclerosis. The prevalence of atherosclerosis vascular disease is markedly increased among individuals with diabetes mell itus and hypertension. An increased thickness of carotid artery wall is thought to be a sign of early atherosclerosis. This study aimed to study the relationship between both serum triglycerides as a traditional risk factor and CRP level ”as non traditional risk factor” and subclinical asymptomatic atherosclerosis in patients with type 2 diabetes mellitus. Jhe study included one hundred patients (forty males and sixty females) with type 2 diabetes mellitus as well as twenty age and sex matched healthy volunteers serving as Gontrols. Age of patients ranged from 40 to 62 years. Patients were selected from those attending the diabetes mellitus clinic at Benha University-Hospitals. A ll patients were subjected to a thorough h istory and complete clinical examination, with special stress on the following: • Duration of DM. • Mode of treatment of DM. • Micro (renal, retinal, neuropathy) and macrovascu lar (coronary, cerebral or peripheral vascular disease) complications of diabetes mell itus. • Measurement of blood pressure. • Fundus examination. • W/H circumference ratio. • Bruit on carotid arteries. The following investigations were done to all subjects: 1- ECG. 2- FPG and 2hr PPG. 3- S. TG level. 4- S. CRP level. 5- Duplex of the extra-cranial carotid arteries. This study showed the following results: • Systolic blood pressure, diastolic blood pressure, BMI, W/H circumference ratio, FPG, PPG, S. TG, S. CRP and IMT were significantly higher in diabetic patients compared to control group. • A significant elevation of serum TG level in both male and female diabetic group when compared to both male and female control group. • No signi ficant d ifference in S. TG level was found between male and female contro l group, and between mal e and female diabetic group. • Serum TG level, S. CRP level and IMT was significantly higher in uncontrolled diabetics compared to controlled diabetics. • Serum TG level was significantly higher in cases with carotid plaques compared to those without plaques. • Serum CRP level was significantly higher in cases with carotid plaq ue compared to those without carotid plaq ues. • A significant positive correlation between TG level and the duration of DM, systolic BP and diasto lic BP, BMI, W/H circumference ratio, FPG, PPG and IMT. • A significant positive correlation between CRP and the duration of DM, systolic BP, diastolic BP, BMI, W/H circumference ratio, FPG, PPG and IMT. • A significant elevation of the level of TG, CRP in cases with more than one plaque compared to those with one plaque. Conclusions: So, we can conclude that subclinical atherosclerosis is a common and frequent complication of type 2 DM. The possi ble implicated risk factors encountered in our work to explain diabetic atherosclerosis include hyperglycemia, duration of DM, hypertension, obesity, W/H circumference ratio, hypertriglyceridemia and elevated serum CRP level. |