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RELATIONSHIPS BETWEEN METABOLIC PARAMETERS AND PLAQUE VULNERABILITY IN THE CAROTID ARTERIES IN PATIENTS WITH DIABETES MELLITUS TYPE 2
Muamer Suljić1 and Aleksandar Jovanović2
Health Centre Novi Pazar, Internal Medicine Department, Novi Pazar1
University of Priština, Faculty of Medicine in Kosovska Mitrovica, Kosovska Mitrovica2
In most patients with type 2 diabetes, along with the presence of disturbances of glycemic control, there are disturbances of lipid metabolism and elevated blood pressure, which are strong risk factors for the development of late, especially macrovascular complications and whose base is the vulnerable atherosclerotic plaque.
This study included a total of 101 individuals (51 patients suffering from diabetes mellitus type 2-DMT2 and 50 healthy subjects). Distribution of respondents according to the presence of hyperlipoproteinaemia, vulnerable and invulnerable atherosclerotic plaque was done. The data were analyzed by appropriate statistical tests.
Hyperlipidaemia was more prevalent in patients with DMT2 than in the control ones (p<0.05). Cholesterol levels were significantly higher (p<0.05) in subjects with DMT2 (5.74±2.69 vs. 4.82±1.11mmol/L) as well as triglycerides (1.94±2.2 compared to 1.6±1.14mmol/L) (p<0.001). Mean values of glucose in the group of subjects with diabetes mellitus type 2 (10.54±3.75mmol/L) and in the control group (4.53±2.14mmol/L) were significantly different (p<0.001). Glycosylated hemoglobin HbA1c was significantly higher in patients with DMT2 (9.30±2.26%) than control group (4.98±0.05%). Mean values of both systolic and diastolic blood pressure were significantly higher in subjects with diabetes mellitus type 2 (149.55±29.27mmHg and 87.92±17.58mmHg) compared to those in the control group (mean systolic blood pressure of 128.32±25.77 and mean diastolic blood pressure 79.11±9.51mmHg). Plaque was found in 100% of diabetic patients, as opposed to 28.12% of patients in the control group. Vulnerable plaque was found in 47.06% of patients in the group with type 2 diabetes and 6.25% in the control group. Analysis with the Mann-Whitney-test shows that the incidence of plaque and vulnerable plaque was significantly higher in DMT2 patients (p<0.001).
Hyperlipidaemia, hypertension and type 2 diabetes mellitus are significantly associated with atherosclerotic changes in the blood vessels. Ultrasound determination of plaque vulnerability in the carotid arteries is one of the most important criteria for the classification of patients at high risk for ischemic stroke and development of DMT2. Acta Medica Medianae 2012;51(3):29-37.
Key words: hyperlipidaemia, hypertension, diabetes mellitus, plaque, carotid arteries