A Study On Carotid Elasticity In Patients With T2DM And Diabetic Nephropathy By ET Technique

Objective:1. To evaluate the effects of strict glycemic control on the carotid elasticity in type 2 diabetes mellitus (T2DM) by ultrasonic E-Tracking technology.2. The present study was to detect the changes of carotid elasticity in patients with diabetic nephropathy in different periods by E-Tracking technique.Methods:1. sixty-eight patients in the five years of T2DM and 54 normal subjects were selected. The stiffness parameters (β), pressure-strain elasticity modulus (Ep), arterial compliance (AC), argumentation index (Al) and pulse wave velocity (PWVβ) of the carotid were assessed and calculated automatically by E-Tracking technology.2. Ninety-three patients with type 2 diabetes (T2DM) and 32 normal controls (NC) were recruited in the study. According to urinary albumin excretion rate (UAER), the patients were made into three groups:normoalbuminuria (DMI), minimal urine protein (DM2) and clinical urine protein (DM3). Carotid vascular intima thickness (IMT), systolic carotid arterial lumen (Ds), peak systolic velocity (PSV) and resistance index (Rl), elastic coefficient (Eρ), hardening index (β), compliance (AC) and single pulse wave velocity(PWVβ) and increase index (Al) were measured using a color Doppler ultrasound.Results:1. Compared with the normal subjects, the value ofβ, Ep, Al and PWVP were increased and AC was lower sigificantly in T2DM (P<0.05). 2. HbA1c in the group of T2DM showed a positive correlation withβ,Ep,AI,PWVβand a negative correlation with AC.3. Compared with the group of T2DM with poor glycemic control, the value ofβ, Ep, Al and PWVβwere decreased and AC was increased sigificantly in the group of T2DM with strict glycemic control (P<0.05).4. Compared with NC, IMT values in T2DM patients were significantly higher (P<0.05); 5. Compared with NC, the values ofβ, Ep, Al and PVWβin T2DM patients increased and AC reduced significantly (P<0.05). Moreover, the values ofβand PVWβin DM3 group were higher than DM1 and DM2 groups, respectively (P<0.05);6. Linear correlation analysis showed that IMT positively related to the parameters ofβ, Ep, A I, PWVβ(P<0.05) and negatively correlated to AC (P<0.05). Logistic regression analysis showed that the UAER positively related to the parameters of PWVβand IMT (P<0.05).Conclusion:1. Strict glycemic control can obviously increase carotid artery elasticity and improve endothelial function.2. The carotid artery elasticity has been changed in diabetes patients with clinical stage kidney. Thus, carotid artery elasticity change could reflect the process of diabetes microvascular disease.