Vnitr Lek 2003, 49(12):967-971

[The carotid drainage system--a "window" into the atherosclerosis process in diabetics?].

A Adamíková: Diabetologické centrum Batovy krajské nemocnice, Zlín.

Macrovascular complications present from the viewpoint of morbidity and mortality the biggest risk in type 2 diabetics. An aim of this work is to show ways of detecting clinical and preclinical phases of atherosclerosis with special regard to carotid system. In our paper we have been presenting a sample of 239 patients with cardiovascular incidents and findings on their extracranial carotid systems detected by duplex sonography. 88 patients (36.8%) in the sample had type 2 diabetes, their average age was 68.2 +/- 8.5. 35 were on a diet, 34 were treated with peroral antidiabetics, and 19 with insulin. Findings on extracranial carotid systems were normal in 27.3% of diabetics, in stenoses up to 50% was lumen in 50%, in stenoses 51-70% was lumen in 15.9%, and in stenoses 71-95% was lumen in 6.8% (compared to 3.9 in nondiabetics). Intimomedial thickness (IMT) in a group with positive microalbuminuria was 0.9 +/- 0.3 mm and in a group with negative microalbuminuria 0.87 +/- 0.18 mm. Intimomedial thickness (IMT) and microalbuminuria (MAU) are the markers of risk for atherosclerosis and enable to detect preclinical stages of atherosclerosis. Another enzyme indicated in the process of atherosclerosis is PAPP-A, an indicator of plaque instability. Early detection and early intervention of the atherosclerotic process can prevent growth of atherosclerosis, especially during epidemic increase of type 2 diabetes.