Renal insufficiency accelerates atherosclerosis in patients with type 2 diabetes mellitus.
Diabetes mellitus is a strong risk factor for the progression of atherosclerosis. In patients with chronic renal failure on hemodialysis, advanced atherosclerosis is reported to be present. We examined how renal insufficiency affects intima-medial thickness (IMT) of the carotid and femoral arteries in patients with type 2 diabetes mellitus. IMT was measured by B-mode ultrasonography in 115 patients with type 2 diabetes mellitus (65 men, 50 women; 58 +/- 13 years old). The IMT of the carotid and the femoral artery of patients with creatinine clearance less than 80 mL/min (n = 55) were significantly greater than those of patients with creatinine clearance 80 mL/min or greater (n = 60; P < 0.01 and P < 0.05). Linear regression analyses showed that there was a significant negative correlation between creatinine clearance and IMT of the carotid artery (r = -0.330; P < 0.001) and femoral artery (r = -0.336; P < 0.001). Multiple regression analyses revealed that age and creatinine clearance significantly and independently affected the IMT of the carotid artery (R(2) = 0.176; P < 0.0001), and age, duration of diabetes, and smoking affected the IMT of the femoral artery (R(2) = 0.287; P < 0.0001). These findings show that decreased renal function accelerates atherosclerosis in patients with type 2 diabetes mellitus and that chronic renal failure is a significant, independent risk factor for carotid atherosclerosis in these patients.
Ishimura
E
E
Second Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan. ish@med.osaka-cu.ac.jp
Shoji
T
T
Emoto
M
M
Motoyama
K
K
Shinohara
K
K
Matsumoto
N
N
Taniwaki
H
H
Inaba
M
M
Nishizawa
Y
Y
D000367:Age Factors; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003404:Creatinine / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D014463:Ultrasonography
D003404:Creatinine