[Long-term intensive glycemic and lipid control ameliorates the carotid intima medial thickness in type 2 diabetes mellitus].
OBJECTIVE
To investigate whether long-term intensive glycemic and lipid control would ameliorate the carotid intima medial thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).


METHODS
IMT was evaluated on B-mode ultrasonography in 116 patients with T2DM. Body mass index (BMI), waist-to-hip ratio (WHR), fasting blood glucose (FBG), 2 hour postprandial glucose (2hPG), hemoglobin A(1)c(HbA(1)c), total cholesterol(TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) were also measured. Of all the patients 89 were divided randomly into group of intensive glycemic and lipid control and group of conventional treatment and underwent 1 year clinical interview.


RESULTS
(1) IMT in patients with T2DM was significantly correlated with age(r = 0.515,P = 0.000) , SBP (r = 0.208, P = 0.025), TC(r = 0.213,P = 0.022), LDL-C(r = 0.253, P = 0.006) and no correlations were found between IMT and BMI,WHR,FBG, 2hPG ,HbA(1)c, TG and HDL-C. In multivariate regression analysis, age (Beta = 0.527, P = 0.000 )and TC(Beta = 0.243, P = 0.002) were significant independent determinants for IMT. (3) After 1 year the change of IMT in the group of intensive glycemic and lipid control was significantly different compared with the group of conventional treatment [(-0.044+/-0.148)mm vs (0.056+/-0.178), P<0.05]. The change of IMT was not significantly associated with the use of Metformin, Sulphonylurea and Aspirin, but significantly associated with the use of statins. The change of IMT in the group using statins was significantly different compared with that in the group without using statins[(-0.053+/-0.153)mm vs (0.042+/-0.165)mm, P <0.05].


CONCLUSIONS
Carotid IMT appears to be closely related to age and TC in the patients with T2DM. long-term intensive glycemic control and lipid control could ameliorate the IMT in patients with T2DM. The improvement of IMT may be associated with the use of statin drug.
Yang
Jian Mei
JM
Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.
Guo
Xiao Hui
XH
Yu
Xiang
X
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002339:Carotid Arteries / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008875:Middle Aged
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids