الفهرس | Only 14 pages are availabe for public view |
Abstract Diabetes mellitus often simply referred to as diabetes; is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. Intima media thickness of the carotid arteries (cIMT) is a validated surrogate marker of early atherosclerosis and is associated with coronary atherosclerosis and with the risk of future vascular events. Because it can be measured relatively simply and noninvasively, it is well suited for use in large-scale population studies. The important role of long-term hyperglycemia in the development of atherosclerosis is known and a correlation between HbA1c and cIMT was demonstrated especially in women and in children affected by type 1 diabetes. The accurate monitoring in critical patients, such as the patients with type 2 diabetes, is crucial since persons with diabetes have 2–6 folds higher cardiovascular risk than subjects without diabetes. Male gender was also associated to a more rapid increase of cIMT even in type 2 diabetes, thus further increasing the need for accurate measurement and monitoring. So, this study aimed to investigate the relation between carotid intimal medial thickness and HbA1c with the severity of coronary artery disease in diabetic patients. To elucidate our results, this was a prospective comparative study carried out on 160 diabetic patients diagnosed with ischemic heart disease recruited from cardiology department in Menoufia university Hospital during the period from September 2019 to March 2021. All patients included in this study were subjected to the following: Full history taking included: Personal history: name, age, sex. Past history: Summary 74 Any medical disease and its nature, duration, treatment and any drug intake and its regimen and duration of intake. Family history: of any similar condition. Medical history taking: presence of HTN, DM and dyslipidemia. General examination: pulse, blood pressure, temperature and respiratory rate, etc. Local examination: examination of the heart to detect abnormal sounds or murmur. Laboratory investigations including: Lipid profile, HbA1C, CBC, INR, serum creatinine and liver function test. Results of this study can be summarized as follows: A total of 160 patients included in this study, the mean age, weight, hight, BMI and duration of DM of the studied patients were (43.35±17.88, 64.70±8.89, 167.94±9.34, 23.15±4.04 and 4.54±2.92), respectively. Most of the studied patients (64.4%) were males. Our patients were classified into 3 groups according to CIMT; Group I (cIMT <0.8) included 56 patients (35%), group II (cIMT, 0.8-1) included 59 patients (43.2%) and group III (cIMT >1.01) included 35 patients (21.9%). The studied patients were further classified according to Gensini score into 3 groups; group A included 46 patients (28.75%) with low Gensini score, group B included 49 patients (43.2%) with moderate Gensini score and group C included 65 patients (30.65%) with high Gensini score. CIMT was significant higher in patients with high Gensini score than other groups (p value <0.05). There was a significant positive correlation between HbA1C and CIMT and both total cholesterol & LDL levels (p value< 0.05). HbA1C (9.92) and CIMT (1.5) were cut values to predict high Gensini score with sensitivity 71.8%, 80.2%, respectively and specificity 68.01, 70.91, respectively. Conclusions 75 CONCLUSIONS Our study concluded that there was a significant positive correlation between CIMT and HbA1C in diabetic patients and both of them were significantly elevated in diabetic patients with severe CAD measured with Gensini score. |