Relationship between carotid atheroma thickness and albuminuria in diabetic patients

Authors

  • Methaq A. M. Hussein Assistant professor, department of medicine, college of medicine / Thi-Qar University
  • Basim Audib Motar Assistant professor, department of medicine, college of medicine / Thi-Qar University
  • Oras Majeed Radiologist, Thi-Qar health Office

Abstract

  Our aim in this study to assess the efficacy of albuminuria in type 2 diabetes mellitus to be as predictor and independent marker of atherosclerosis by measurement of carotid intimal-medial thickness (CIMT)  by high frequency ultrasonography. One hundred twenty participants in this study, 45 as a control healthy person and the others 75 patients with type 2 diabetes mellitus were included in this study. We divided into three groups: group 1 which is the control group, and group 2 those patients who are the diabetic without albuminuria, and group 3 are the diabetic patients with albuminuria. The intimal-medial thickness (IMT) was measured by high frequency ultrasonography. Other laboratory investigations were measured like HbA1c, fasting blood sugar, lipid profile. The intimal-medial thickness (IMT) was found higher in group 3 than group 1 and group 2 (P value < 0.05). In conclusion, there is a significant association between micro- albuminuria and IMT as a marker of atherosclerosis in type 2 diabetes mellitus.

References

- Unoki H, Takahashi A, Kawaguchi T, et al. SNPs in KCNQ1 is associated with susceptibility to type 2 diabetes in East Asian and European populations. Nat Genet. 2008; 40: 1098-1102.

- Abdul-Ghani MA, Matsuda M, Jani R, et al. The relationship between fasting hyperglycemia and insulin secretion in subjects with normal or impaired glucose tolerance. Am J Physiol Endocrinol Metab. 2008; 295: E401-E406.

- Momeni A, Beharadmanesh MS, Kheiri S, Horestani MK. Evolution of spironolactone plus hydrochlorothiazide in reducing proteinuria in type 2 diabetic nephropathy. J Renin Angiotensin Aldosterone Syst. 2013.

- K/DOQ1 clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney dissing 2007; 49(2 Suppl 2): S12.

- Gross JL, de Azevedo MJ, Silveiro SP, et al. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care 2005; 28:164.

- Ruggenenti P, Remuzzi G. Nephropathy of type 2 diabetes mellitus. J Am Soc Nephrol 1998; 9:2157.

- Ismail N, Becker B, Strzelczyk P, Ritz E. Renal disease and hypertension in non-insulin-dependent diabetes mellitus. Kidney Int 1999; 55:1.

- Mogensen CE, Vestbo E, Poulsen PL, et al. Microalbuminuria and potential confounders. A review and some observations on variability of urinary albumin exretion. Diabetes Care 1995; 18:572.

- Eknoyan G, Hostetter T, Bakris GL, et al. Proteinuria and other markers of chronic Kidney disease: a position statement of the national Kidney foundation (NKF) and the national institute of diabetes and digestive and kidney diseases (NIDDK). Am J Kidney Dis 2003; 42:617.

- Newman DJ, Mattock MB, Dawnay AB, et al. Systemic review on urine albumin testing for early detection of diabetic complications. Health Technol Assess 2005; 9: III.

- Advance Collaborative Group, Patel A, MacMahon S, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358:2560.

- Adler Al, Stevens RJ, Manley SE, et al. Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes study (UKPDS 64). Kidney Int 2003; 63:225.

- Young BA, Katon WJ, Von Korff M, et al. Racial and ethnic differences in microalbuminuria prevalence in a diabetes population: the pathways study. J Am Soc Nephrol 2005; 16:219.

- Parving HH, Lewis JB, Ravid M, et al. Prevalence and risk factors for microalbuminuria in a referred cohort of type 2 diabetic patients: a global perspective. Kidney Int 2006; 69:2057.

- Perkovic V, Verdon C, Ninomiya T, Barzi F, Cass A, Patel A, et al. The relationship between proteinuria and coronary risk: a systematic review and meta-analysis. PLos Med. 2008; 5(10).

- C. D. A. Stehouwer, M. A. Gall, J.W.R. Twisk, E. Knudsen, J. J. Emeis, and H. H. Parving, '' Increased urinary albumin excretion, endothelial dysfunction: progressive, interrelated, and independency associated with risk of death, " Diabetes, vol. 51, no. 4 pp.1157-1165, 2002.

- H. Yokohama, J. S. Jensen, B. Myrup, E. R. Mathiesen, B. Ronn, and T. Deckert, '' Raised serum sialic acid concentration precedes onset of microalbuminuria in IDDM: a 10-year follow up study,'' Diabetes Care, vol. 19, no. 5, pp. 435 - 44–, 1996.

- T. Jensen, J. Bjerre-Knudsen, B. Feldt-Rasmussen, and T. Deckert,'' Features of endothelial dysfunction in early diabetic nephropathy,'' The Lancet, vol. 1, no. 8636, pp. 461-463, 1989.

- T. Deckert, B. Feldt-Rasmussen, K. Borch-Johnsen, T. Jensen, and A. Kofoed-Enevoldsen, '' Albuminuria reflects widespread vascular damage. The steno hypothesis,'' Diabetologia, vol. 32, no. 4, pp. 219-226, 1989.

- T. Deckert, T. Jensen, B. Feldt-Rasmussen, A. Kofoed-Enevoldeen, K. Borch-Johnsen, and S. Stender, '' Albuminuria a risk marker of atherosclerosis in insulin dependent diabetes mellitus,'' Cardiovasc Risk Factors, no. 1, pp. 347-360, 1991.

- Nichols WW, Pepine CJ, O'Rourke MF. Carotid – artery intima and media thickness as a risk factor for myocardial infarction and stroke. N Engl J Med. 1990; 340:1762-3.

- Kota SK, Mahapatra GB, Naveed S, Tripathy PR, Jammula S, Modi KD. Carotid intima media thickness in type 2 diabetes mellitus with ischemic stroke. Indian J Endocrinol Metab. 2013; 17:716-22.

- Nathan DM, Lachin J, Cleary P, et al. Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus. N Engl J Med. 2003; 348:2294-303.

- Ito H, Komatsu Y, Mifune M, Antoku S, Ishida H, Takeuchi Y, et al. The estimated GFR, but not the stage of diabetic nephropathy graded by the urinary albumin excretion, is associated with the carotid intima-media thickness in patients with type 2 diabetes mellitus: a cross-sectional study. Cardiovasc Diabetol.2010; 9:18.

- Temelkova-Kurktschiev TS, Koehler C, Leonhardt W, Schaper F, Henkel E, Siegert G, et al. Increased intimal-medial thickness in newly detected type 2 diabetes: risk factors. Diabetes Care. 1999; 22(2):333-8.

- Bernard S, Serusclat A, Targe F, Charriere S, Roth O, Beaune J, et al. Incremental predictive value of carotid ultrasonography in the assessment of coronary risk in a cohort of asymptomatic type 2 diabetic subjects. Diabetes Care.2005; 28(5):1158-62.

- Shinoda-Tagawa T, Yamasaki Y, Yoshida S, Kajimoto Y, Tsujino T, Hukui N, et al. A phosphodiesterase inhibitor, cilostazol, prevents the onset of silent brain infarction in Japanese subjects with type 2 diabetes, Diabetologia, 2002;45(2):188-94.

- P.S. Sidhu and S.R. Desai, " A simple and reproducible method for assessing intimal-medial thickness of the common carotid artery,'' British Journal of Radiology, vol.70, pp. 85-89, 1997.

- J. T. Salonen and R. Salonen, '' Ultrasonographically assessed carotid morphology and the risk of coronary heart disease,'' Arteriosclerosis and Thrombosis, vol. 11 no. 5, pp. 1245-1249, 1991.

- J. T. Johnson, M. M. Kennelly, and D. Decesare, '' Natural history of asymptomatic carotid plaque, '' Archives of surgery, vol. 120, no. 9, pp. 1010-1012, 1985.

- N. Nand, R. Jain, S. Seth, J. Sen, and M. Sharma, '' a new marker of carotid atherosclerosis in middle aged adults: cystatin cormicroalbuminuria, '' Indian Heart Journal, vol. 62, no. 4, pp. 320-323, 2010.

- C. D. A. Stehouwer, R. M. A. Henry, J. M. Dekker, Nijples, R. J. Heine, and L. M. Bouter, '' Microalbuminuria is associated with impaired brachial artery, flow-mediated vasodilatation in elderly individuals without and with diabetes: further evidence for link between microalbuminuria and endothelial dysfunction – the Hoorn Study,'' Kidney International, vol.66, supplement 92, pp. S42-S44, 2004.

- Yu-Hong Zhang, Yuan Gao, Xin Mao, Jing Shang, and Ben-Li Su, ''Assessment of Carotid Atherosclerosis in Type 2 Diabetes Mellitus Patients with Microalbuminuria by High-Frequency Ultrasonography,'' International Journal of Endocrinology, vol. 2013, Article ID 819584, 6 pages.

- Dick de Zeeuw, '' Albuminuria, just a Marker for Cardiovascular Disease, Or Is It More?'' J Am Soc Nephrol 2005; 16:1883-1885.

- M. Furtner, S. Kiechl, A. Mair, et al., '' Urinary albumin excretion is independently associated with carotid and femoral artery atherosclerosis in the general population,'' European Heart Journal, vol.26, no. 3, pp. 279-287, 2005.

- C. D. Saudek and J. C. Brick, '' The clinical use of hemoglobin A1c,'' Journal of diabetes Science and Technology, vol. 3, no. 4, pp. 629 – 634, 2009.

Downloads

Published

2020-10-08

Issue

Vol. 11 No. 1 (2016)

Section

ARTICLE