[Carotid artery plaque in patients with disorders of glucose regulation].

PURPOSE: The aim of this study was measurement of artery intima media thickness (IMT) and plaques as an early indicator of atherosclerosis in diabetics comparing with other risk factors of carotid artery. METHODS AND MATERIALS: 110 pts: 50 with Diabetes Mellitus, type 1 (25) and type 2 (25), 20 pts with glucose intolerance, 20 pts with type 2 de novo and 20 pts obese without diabetes. Ultrasound examination (using 7.5 MHz sound on Toshiba SSA-270A) end measurement of intima-media ticknes (IMT) were performed on Carotis communis (CCA), bifurcation and distal from bifurcation to a.carotis intern (ACI), expressed in mm. Plaques were correlated with other common factors age, BP, lipid parameters (Chol, HDL, LDL, Triglycerides), smoks, alcoholism and obese (BMI). The authors used 2 test and Spearman's correlation. RESULTS: The lowest percent of plaques was found in group with type DM 1. The highest percent of plaques was found in type DM 2. Statistically there is highly significant difference between plaques founded on type 2 DM and types 2 DM de novo and on other types. CONCLUSION: DM is not an independent risk factor for developing of macroangiopathic changes an arterial walls, but their appirience are more presenting in diabetic patients. The highest number of plaques are presenting DM type 2 (29.6%), and after type 2 de novo (26.8%), the next highest position of plaques were in patients with obese but without DM and intolerantio glucosae (IFG+IGT) (17.1%) and type 1 DM (9.8%). Risk factors were presented in following percentage: Obese 80.5% pts; hyperlipidema 53.7% pts; HTA 51.3%; smoking 51.2% pts and alchocholism 2.4% pts. According to these results, all risk factors were included in patophysiology of plack forming except alcoholism. Influences of these risk faktors are very importance and their synergic action lids to their rapid appirience and clinical manifestations. DM has specific position in patophisiology of atherosclerosis.

[Correlation of metabolic parameters and changes in the intima-media complex in non-diabetic obesity and patients with various disorders of glucose regulation].

UNLABELLED: Measurement of intima-media thickness (IMT) of carotid artery by ultrasound, is well known method. Using this noninvasive method in various risck factors such as diabetes mellitus, dislipidemia, hypertension, smoking, age, obesity could be very usefull in pathophisiology studies of atherosklerosis. PURPOSE: The aim of this study was to measure intima media thickness (IMT) of carotid artery, as an early indicator for development of atherosclerosis, and too estemate if there is any significant differences between investigated groups of pts (diabetics pts, pts with glucose intolerance and obese pts without diabetes an older than 45 years). METHODS AND MATERIALS: 110 pts were devided in five groups: three groups of diabetics pts: type 1 DM (25) pts, type 2 (25) pts and type 2 DM de novo (20), and (20) pts with glucose intolerance, and 20 pts obese without diabetes, older than 45 years of age. Correlation of metabolic parameters (body mass index (BMI), hip circumference (OS), lipid status) with IMT was performed as well as hipertension, age, sex, smoking and alcohol abuse. STATISTICS: The authors used 2 test and Spearman's correlation. RESULTS: Intima media ticknes (IMT) was highly statisticly significant in groups of DM type 2 and DM tipe 2 de novo. IMT was stat. sig. in pts with high values of BMI and hip circumference according to those pts with normal values. It was also stat. sig. in pts with smoking hiperlipoproteinemia and hipertension. There was no stat. sig. correlation of IMT with sex, age and alcohol abuse. CONCLUSION: This study showed that diabetics pts have frequent patological changes on arteri vessels and these changes are difuse and frequently with complicated wall leasens. The influence of these risck factors is very important because their sinergetic effects may augment clinical manifestation of atherosclerosis.

[Echosonography in diagnostics of carotid artery disease].

Color duplex scanning is important method in diagnostics of carotid stenosis disease (CSD). This method is accurate in estimation of stenosis degree and plaque quality characteristics as potential source of embolus. It enable the approach to extracranial as mostly affected segments of carotid arteries, frequent follow up of asymptomatic clinical course of the disease and inspection in local chemodynamic flow parameters. Beside numerous advantages, in cases of severe degree stenosis of echolucent or heterogeneous calcificant plaques, estimation of stenosis degree is inaccurate and than the use maximal flow velocities for stenosis degree estimation is better. Unfortunately in this situation some local carotid changes like multiple carotid plaques, significant proximal or distal concomitant stenosis as well as some disease like arterial hypertension, aortic valve disease, arrhythmia absoluta etc. may over or underestimate the stenosis degree, and thus make impossible the right diagnosis.