Y. Yamasaki et al., ASYMPTOMATIC HYPERGLYCEMIA IS ASSOCIATED WITH INCREASED INTIMAL PLUS MEDIAL THICKNESS OF THE CAROTID-ARTERY, Diabetologia, 38(5), 1995, pp. 585-591
Citations number
44
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
Atherosclerotic changes have not been demonstrated directly in asympto
matic hyperglycaemic non-diabetic subjects, although high mortality du
e to coronary heart disease has been reported. We measured arterial wa
ll thickness non-invasively, in order to directly demonstrate atherosc
lerosis of the carotid arteries of hyperglycaemic non-diabetic subject
s and to evaluate its risk factors. The thicknesses of the intimal plu
s medial complex (IMT) of the carotid arteries of 112 asymptomatic hyp
erglycaemic non-diabetic subjects (aged 22-81, 95 males and 17 females
) were compared with those of 55 healthy male subjects and 211 non-ins
ulin-dependent NIDDM male diabetic patients. The subjects were subgrou
ped into impaired glucose-tolerant (IGT) subjects who had a 2-h glycae
mic level of more than 7.8 mmol/l, and non-IGT subjects whose 2-h glyc
aemic levels were within 6.7-7.7 mmol/l. Non-IGT and IGT subjects show
ed significantly greater IMTs than age-matched healthy males and showe
d no significant differences compared to age-matched NIDDM patients. M
ultivariate analysis demonstrated that the risk factors for IMT of non
-IGT and IGT subjects were age and systolic blood pressure. According
to data on the accumulation of atherogenic risks (hypertension, dyslip
idaemia, and smoking), IMT increased linearly in non-IGT and IGT subje
cts. However, non-IGT and IGT subjects without hyperlipidaemia, hypert
ension, or smoking risk still had significantly greater IMT than age-m
atched normal males (1.019+/-0.063 vs 0.770+/- 0.111 mm, p < 0.05). Pr
evalence of EGG-indicated coronary heart disease was significantly hig
her in hyperglycaemic non-diabetic subjects and NIDDM with increased c
arotid arterial wall thickness (IMT greater than or equal to 1.1 mm) t
han in those without increased thickness (IMT < 1.1 mm). Asymptomatic
hyperglycaemic non-diabetic subjects have increased thickness of their
carotid arteries compared to age-matched male NIDDM patients. As one
of several independent risk factors, mild hyperglycaemia advances athe
rosclerosis, which leads to coronary heart disease.