The Possible Effects Of Different Hypoglycemic Agents On The Changes Of Carotid Intima-media Thickness During Long-term Follow-up Of Type 2 Diabetes

[Background]The alarming increase in prevalence of type 2 diabetes and prediabetic state in adults has become a global health problem in recent years.The striking growing numbers of type 2 diabetes ranking first in the world,being a tremendous economic burden in China.As a metabolic disorder,it damages the inner linings of the blood vessels in early stage and large canvas,leading to cardiovascular disease.It is very useful to screen in early stage by accurate noninvasive test.rCarotid intima-media thickness and coronary atherosclerosis have the similar pathophysiology mechanism,and it is easily detected as it located superficially.[Objective](1)To observe the baseline charact of our following-up cases.(2)To assess the effects of different antihyperglycemic agents on the change of CIMT/carotid atherosclesis and the annual rate of change.[Methods]We conducted a retrospective study consisted of 158 adults aged 18-80years old from Peking Union Medical College Hospital out-patient between January,2012 to December,2016.Carotid intima-media thickness(CIMT)was diagnosed by European Hypertensive Society Guidelines 2007.Principal factors were the change of CIMT,its annual rate of change,the change of carotid artery atherosclerosis and the annual rate of change.The concrete mathematical methods will be introduce below.CIMT was divided into thickening and thinning.The change of atherosclerosis was divided into thickening,stabilizing,and thinning,three state groups.Self-reported information on basicdate,lifestyle and the history of chronic disease were collected by questionnaire.Anthropometric measurements included hight,weight,waist circumference(WC),fat mass percentage(FAT%)and blood pressure.Blood samples were analyzed for concetrations of fasting plasma blood glucose(FPG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C).Urine sample was analyzed for urinary protein to creatinine.There there different groups of glucose-lowering therapies.Each group was divided into two different cases.Comparisons were made among groups using t test or analysis of variance(ANOVA)or chi-square test.Multivariate logistic regression analysis was performed to multivariate analysis.[Results]In 158 cases diagnosed T2DM,the number of male was 90(57%),female was 68(43%).The number of smokers was 54(34%),the number of hypertension,hyperlipidemia,CIMT and cases with family history of T2DM were 83(53%),148(94%),130(82%)and 96(61%)respectively.There was no any statistics significance in the comparison among groups,but we have seen a tiny tendency among the third group.Among the first group,there was statistics significance in GA%,HbAlC%,FPG,HOMA-IR,C-peptide and HDL-C.Multivariate logistic regression analysis showed a statistics significance in HbAlC%.Among the second group,there was statistics significance in Wt,T2DM course,HbA1C%,C-peptide.Multivariate logistic regression analysis showed a statistics significance in T2DM course.Among the third group,there was a statistics significance in WT,T2DM course,DBP,FPG,HbA1C%,GA%,C-peptide,sex,somker.Multivariate logistic regression analysis showed a statistics significance in HbA1C%and T2DM course.[Conclusions](1)Type 2 diabetes always combined with other chronic illness like hyperlipidemia and hypertension,with relative high prevalence of cardiovascular diseases,carotid intima-media thickness can be a useful predict of CVD.(2)There was no significant difference between three different glucose-lowing therapies in our study.(3)In a prolonged course,the progressive change of CIMT is more apparent.Stable glycaemic-control will be benefit.