The Research On E-tracking Technology Evaluating Main Artery Elasticity In Patients With Type 2 Diabetes Mellitus

Objective:E-Tracking technology was used to evaluate the early changes of vascular elasticity in patients with type 2 diabetes mellitus, the correlation with the high risk factors and the diagnostic value of echo tracking technique in early arteriosclerosis were studied statistically, then provide a reliable,objective diagnosis of early arteriosclerosis(AS).Methods: 60 cases of type 2 diabetes mellitus patients,aged 30-79 years old,mean age 46.86y(46.86±13.97), diagnosed based on 1999 ADA diabetes mellitus standard. Exclusion criteria: hypertension,coronary heart disease,valvular disease,stroke,et al; 60 cases of healthy people in control group,aged 14-80 years old,mean age 44.72y(44.72±11.27).SSD-α10 color Doppler ultrasonograghy apparatus produced by Japan Aloka Company is applied. Echo-tracking was used to evaluate the IMT and the elastic indexes,include stiffness parameter(β),the pressure-strain elastic modulus(Ep),arterial compliance(AC),one-point pulse wave velocity(PWVβ) of CCA and CFA ,combination of the clinical and laboratory test results such as age, blood pressure, fasting blood glucose, HbA1C, lipids and other indicators were statistically analyzed. Statistics analysis are treated by SPSS15.0 package, two independent samples t test was used to analysis the data between the two groups; Pearson and Spearman parameters to do the test in condition of different situations between the indexes; the area under the ROC curve was used to determine the diagnosis value and the cut-off value in type 2 diabetes mellitus early artery arteriosclerosis by echo tracking technology; then the cut-off value was used to compare the arteriosclerosis rate between CCA and CFA by two matched-samples chi-square test. Results:1. Compared with the control group, when the IMT both in carotid artery and common femoral artery were thinner than 1.0mm, the Ep,β,PWVβand IMT in type 2 diabetes mellitus were higher, and AC was lower, there were significance differences (P<0.01).2. In control group, age was positively correlated withβ,Eρ,PWVβand negatively correlated with AC of the carotid artery. While in femoral artery, the correlation between age and ET indexes showed no significance.3. In type 2 diabetes mellitus group, the ET indexes Ep,β,PWVβwere positively correlated with FBG,HbA1C,PP and AC was negatively correlated with FBG,LDL,HbA1C,PP both in carotid artery and femoral artery(P﹤0.05).4. The area under ROC curve respectively toβ,Ep,PWVβand AC were 0.81,0.85,0.86,0.77 in carotid artery and 0.84,0.85,0.86,0.75 in femoral artery.5. There was no significance difference between carotid artery and femoral artery arteriosclerosis based on the considered cut-off value.6. The difference between the E-Tracking and IMT diagnosis was significance.Conclusion:1. Type 2 diabetes mellitus patient's artery elasticity decreased before structural changes, E-Tracking technique more sensitive in the evaluation of the artery elastic than IMT.2. The areas under ROC curve were between 0.7~0.9, it means Echo tracking to be a technique of higher diagnosis value in early arteriosclerosis.3. In this study, It is suggested thatβ8.50,Ep108.5kPa,PWVβ6.65m/s,AC0.76 mm2/kPa andβ11.25,Ep130.5kPa,PWVβ7.05m/s,AC0.74 mm2/kPa respectively are employed as the cut-off value of the carotid artery and femoral artery early arteriosclerosis in type 2 diabetes mellitus patients.4. The artery elastic decrease in the type 2 diabetes mellitus related with age,fasting glucose,HbA1C,lipid metabolism and pulse pressure.5. There difference between carotid artery and femoral artery arteriosclerosis make no statistic significance. 6. E-tracking has advantage in real-time obtainment of primitive data, repetition, non-invasiveness and easy operating. It provides rapid, accurate method for diagnosis and study on AS. The data can be analyzed off-line in E-tracking. It is appropriate for large sample epidemiological study and follow-up. It can be used for examination and surveillance on high-risk population.