Vnitr Lek 2008, 54(3):229-237

Macrovascular and microvascular complications in type 2 diabetes patients

H. Rosolová^*, B. Petrlová, J. Šimon, P. Šifalda, I. Šípová, F. Šefrna

II. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta doc. MUDr. Jan Filipovský, CSc.

The prevalence of chronic vascular complications is higher in patients with type 2 diabetes mellitus (DM2).
The objective of our cross-sectional study was to assess the incidence and types of macrovascular (MVC) and microvascular (mvc) complications and to analyse their relation to the different risk factors and biomarkers in order to improve their prevention.


Set of patients and methodology:
415 patients (219 men and 196 women) with an average age of 66 ± 9 years enrolled in the study. A total of 95 % of patients with DM2 had a history of hypertension, 27 % had MVC (of which 55 % had ischaemic heart disease), and 54 % had mvc (of which 95 % had diabetic nephropathy).

Results:
The patients with vascular complications were significantly older and had a longer history of DM2; they did not differ for their systolic blood pressure, but had a higher pulse pressure and took more antihypertensives. They did not differ for their lipid levels or the respective therapy. Diabetic patients with MVC and mvc had higher insulin resistance, higher plasmatic levels of total homocysteine and a higher incidence of albuminuria or proteinuria. The factors which significantly and independently associated with MVC were male gender, age over 60 years, higher hs-C-reactive protein (hs-CRP) exceeding 1 mg/l, glycaemia over 5.6 mmol/l, lower diastolic blood pressure and lower HDL-cholesterol; mvc associated with higher age over 60 years, a history of DM2 exceeding 8 years, and hs-CRP above 1 mg/l.

Conclusion:
Our results show that patients with DM2 have a high incidence of vascular complications significantly associated with age, DM2 history and higher hs-CRP, irrespective of the other monitored parametres.

Keywords: type 2 diabetes mellitus; cardiovascular diseases; microvascular complications; hs-C-reactive protein

Received: January 14, 2008; Accepted: January 21, 2008; Published: March 1, 2008  Show citation