Relationship Between Carotid Artery Intima-media Thickness And Renal Function In Diabetes Mellitus

Objective To investigate the relationship between carotid artery intima-media thickness and renal function in patients with diabetes mellitus.Methods 424 patients of type 2 diabetes without dialysis were enrolled in a cross-sectional study, according to the artery intima-media thickness, patients were divided into normal group and increased thickness group, according to the estimated glomerular filtration rate(eGFR),patients were further divided into eGFR≥60 and eGFR<60 subgroups. All patients according to UAER or 24 h urinary protein were divided into normal proteinuria group, micro proteinuria group and clinical proteinuria group. Biochemical examination, eGFR, and carotid intima-media thickness between different groups were compared. Using Pearson or Spearman correlation analyze the relationship between eGFR, IMT and other parameter. Risk factors for eGFR decline were analyzed by binary logistic regression.Results Compared with normal group, patients in the increased thickness group are older[(63.3±10.2) year vs(52.5±10.6) year, P < 0.05], and undergo longer duration of diabetes[(8.9±6.7) year vs(6.2±5.7) year, P < 0.05], their level of eGFR was decreased[(75.92±28.00) ml/min vs(91.64±24.05) ml/min,P < 0.05], while plaque incidence(71.3% vs 18.3%, χ2=112.42, P<0.01) and prevalence of hypertension(56.4% vs 29.6%, χ2=27.22, P < 0.01) increased. Compared with the normal proteinuria group, the carotid artery IMT(P<0.05) and the incidence of atherosclerotic plaque(P<0.01) were higher in the micro proteinuria group and clinical protein group. Correlation analysis showed that IMT was positively correlated with age(r = 0.503,P<0.01), duration of diabetes(r = 0.204,P<0.01), 24 h urine protein(r = 0.175,P<0.05), but negatively correlated with eGFR(r =-0.307,P<0.01). Logistic regression analysis showed that age, serum uric acid, 24 h urine protein and carotid artery intima-media thickness were independent risk factor for eGFR decline[OR=1.115,95%CI(1.053,1.165),P<0.001;OR=1.008,95%CI(1.002,1.014),P=0.006;OR=1.492,95%CI(1.170,1.903),P=0.001;OR=1.619,95%CI(1.121,2.339),P=0.010].Conclusion Carotid artery intima-media thickness is an independent risk factor for kidney function decline in patients of diabetes.