Tom 15, Nr 5 (2020)
Praca badawcza (oryginalna)
Opublikowany online: 2020-12-30
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Sztywność tętnic szyjnych u pacjentów z cukrzycą typu 2
DOI: 10.5603/FC.2020.0048
Folia Cardiologica 2020;15(5):333-342.
Streszczenie
Zmiany czynnościowe tętnic szyjnych, które są wyrażone wskaźnikami sztywności, są marekrem subklinicznego uszkodzenia narządowego u pacjentów z cukrzycą typu 2 (T2D) Istnieją kontrowersje w jakim stopniu cukrzyca per se a w jakim stopniu inne czynniki ryzyka miażdżycy wpływają na sztywność naczyń. Celem pracy była ocena sztywności tętnic szyjnych u pacjentów z niepowikłaną T2D. Zbadaliśmy zależność między klasycznymi czynnikami ryzyka sercowo-naczyniowego i wartością hemoglobiny glikowanej a sztywnoścą tętnic w cukrzycy. Materiał stanowiło 168 chorych, w tym 84 pacjentów z cukrzycą typu 2 oraz 84 zdrowe osoby stanowiące grupę kontrolną. Metodą echo-tracking oceniono sztywność tętnic szyjnych za pomocą następujących parametrów: β, Ep, AC, AI, PWV-β. Pacjenci z cukrzycą typu 2 mieli istotnie wyższe wartości wskaźników sztywności tętnic szyjnych (β stiffness, EP, AI, PWV-β) w porównaniu do grupy kontrolnej. W grupie pacjentów z cukrzycą w analizie regresji wielokrotnej uzyskano natępuące istotne modele parametrów sztywności: β = 1,8 + 0,096 ⋅ PP + 0,07 ⋅ wiek; R2 = 0,166, Ep = 16,7 + 1,852 ⋅ PP; R2= 0,286, AC = 1,9 – 0,005 ⋅ Ps - 0,007 ⋅ HR + 0,14 ⋅ Papierosy; R2 = 0,165, AI = 18,0 - 0,80 ⋅ BMI + 0,40 ⋅ wiek; R2 = 0,147. PWV-β = -0,4 + 0,77 ⋅ Ps – 0,72 ⋅ MAP – 0,50 ⋅ PP + 0,03 ⋅ HR; R2 = 0,235, Wnioski: T2D jest silnym niezależnym czynnikiem sztywności tętnic. U pacjentów z T2D niezależnymi determinanatmi parametrów sztywności tętnic były wiek, SBP, MBP, PP, HR, BMI oraz palenie papierosów. Nie tylko kontrola glikemii, ale także wieloczynnikowa strategia prewencyjna może odgrywać istotną rolę w zapobieganiu rozwojowi sztywności naczyń oraz subklinicznym uszkodzeniom narządowym w cukrzycy.
Słowa kluczowe: sztwyność naczyńcukrzyca. hemoglobina glikowana
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