Osman Can YONTAR, Alpaslan KARABULUT, Serhat İÇAĞASIOĞLU, Cesur GÜMÜŞ, Fatih KILIÇLI, Fettah ACIBUCU

Relationship between coronary artery calcification and various biomarkers in type 2 diabetic patients

Amaç. Kardiyovasküler hastalık Tip 2 Diabetes Mellitus ta mortalitenin en sık görülen nedenidir.Bu çalışmada Tip 2 diyabetik hastalarda, koroner arterdeki kalsifikasyon varlığı ile biyokimyasalparametreler ve aterosklerozun klasik risk faktörleri arasındaki ilişki incelendi Yöntemler.Çalışmaya, semptomatik koroner arter hastalığı (KAH) yada geçirilmiş miyokard infarktüsüolmayan ve böbrek fonksiyonları normal olan, 41 (27 kadın, 14 erkek) Tip 2 diyabetik hasta alındı.Çok Kesitli Bilgisayarlı Tomografi (ÇKBT) ile koroner arter kalsiyum skorlaması (KAKS)yapıldı. Hastalar KAKS=0 ve KAKS>0 olarak 2 gruba ayrıldı. Bulgular. 12 (%29,3) hastadakoroner arterlerde kalsifikasyon saptandı. Bel çevresi, sistolik kan basıncı, total kolesterol, düşükdansiteli lipoprotein ve trigliserid seviyeleri ile KAKS arasındaki ilişki önemli bulundu (p

Tip 2 diyabetik hastalarda koroner arter kalsif ikasyonu ile biyokimyasal değişkenler arasındaki ilişki

Aim. Cardiovascular disease is the most common made of mortality in type 2 diabetes mellitus.This study investigated the relationship between the presence of calcification in coronary arteryand biochemical parameters alone with the classic risk factors of atherosclerosis in patients withtype 2 diabetes. Methods. Forty one (27 female and 14 male) patients with type 2 diabetes withoutsymptomatic coronary artery disease (CAD) or previous myocardial infarction and with normalkidney functions were included in the study. Multislice Computerized Tomography (MSCT) wasused for coronary artery calcium scoring (CACS). Patients were classifed into two groups asCACS=0 and CACS>0. Results. In 12 (29.3%) patients coronary artery calcification was noted.Waist circumference, systolic blood pressure, total cholesterol, low-density lipoprotein, andtriglyceride levels were significantly different between those with (CACS>0) and without(CACS=0) (p

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1. Merz CN, Buse BJ, Tuncer D, Twillman GB. Physician attitudes and practices and patient awareness of the cardivasculary complications of diabetes. J Am Coll Cardiol 2002; 40:1877-81.
2. Haffner SM, Lehto S, Ronnemaa T, Pyrola K, Laakso M. Mortality from coronary heart disease in subject with type 2 diabetes and in nondiabetic subject with without prior myocardial infarction. N Eng J Med 1998; 339: 229-34.
3. Anand DV, Lim E, Darko D, Bassett P, Hopkins D, Lipkin D, Corder R, Lahiri A. Determinants of progression of coronary artery calcification in type 2 diabetes role of glycemic control and inflammatory/vascular calcification markers. J Am Coll Cardiol 2007; 50: 2218-25.
4. Chambless L, Keil U, Dobson A, Mähönen M, Kuulasmaa K, Rajakangas AM, Löwel H, Tunstall-Pedoe H. Population versus clinical view of case fatality from acute coronary heart disease: results from the WHO MONICA Project 1985- 1990. Multinational MONItoring of Trends and Determinants in CArdiovascular Disease. Circulation 1997; 96: 3849-59.
5. Janowitz WR, Agatston AS, Kaplan G, Viamonte M Jr. Differences in prevalence and extent of coronary calcium detected by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol 1993; 72: 247-54.
6. Yenigün M. Kardiyovasküler Diabet. Ed: Yenigün M, Altuntaş Y, Her yönüyle diabetes mellitus. 2. baskı, İstanbul, Nobel Tıp Kitabevleri 2001; 639-97.
7. Çakır N. Diabetes Mellitus ve Ateroskleroz İlişkisi. Turkiye Klinikleri J Int Med Sci 2007, 3: 61-7.
8. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827-32.
9. Yoshida M, Takamatsu J, Yoshida S, Tanaka K, Takeda K, Higashi H, Kitaoka H, Ohsawa N. Scores of coronary calcification determined by electron beam computed tomography are closely related to the extent of diabetes-specific complications. Horm Metab Res 1999; 31: 558-63.
10. Schurgin S, Rich S, Mazzone T. Increased prevalence of significant coronary artery calcification in patients with diabetes. Diabetes Care 2001; 24: 335-8.
11. Cerqueira MD. EBCT: Identifying the Vulnerable Patient CME. 51 st Scientific Session of the American Collage of Cardiology Atlanta, Georgeia 2002; 3: 17-20.
12. Mielke CH, Shields JP, Broemeling LD. Coronary artery calcium, coronary artery disease, and diabetes. Diabetes Res Clin Pract 2001; 53: 55-61.
13. Khaleeli E, Peters SR, Bobrowsky K, Oudiz RJ, Ko JY, Budoff MJ. Diabetes and the associated incidence of subclinical atherosclerosis and coronary artery disease: implications for management. Am Heart J 2001; 141: 637-44.
14. Raggi P, Shaw JL, Berman SD, MD, Callister TQ. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 2004; 43: 1663-9.
15. Elkeles RS, Godsland IF, Rubens MB, Feher MD, Nugara F, Flather MD. The progress of coronary heart disease in Type 2 diabetes as measured by coronary calcium score from electron beam computed tomography (EBCT): The PREDICT study. Atherosclerosis 2008; 197: 777-83.
16. Elkeles RS, Feher MD, Flather MD, Godsland IF, Nugara F, Richmond W, Rubens MB, Wang D. For the PREDICT Study Group. The association of coronary calcium score and conventional cardiovascular risk factors in Type 2 diabetic subjects asymptomatic for coronary heart disease (The PREDICT Study). Diabet Med 2004; 21: 1129-34.
17. Godsland IF, Elkeles RS, Feher MD, Nugara F, Rubens MB, Richmond W, Khan M, Donovan J, Anyaoku V, Flather MD. For the PREDICT Study Group. Coronary calcification, homocysteine, C-reactive protein and the metabolic syndrome in Type 2 diabetes: The Prospective Evaluation of Diabetic Ischaemic Heart Disease by Coronary Tomography (PREDICT) Study. Diabet Med 2006; 23: 1192-200.
18. Arad Y, Newstein D, Cadet F, Roth M, Guerci AD. Association of multiple risk factors and insulin resistance with increased prevalence of asymptomatic coronary artery disease by an electron beam computed tomographic study. Arterioscler Thromb Vasc Biol 2001; 21: 2051-8.
19. Mazzone T, Meyer PM, Kondos GT, Davidson MH, Feinstein SB, DAgostino RB, Perez A, Haffner SM. Relationship of traditional and nontraditional cardiovascular risk factors to coronary artery calcium in type 2 diabetes. Diabetes 2007; 56: 849-55.
20. Kozan Ö, Savaş İZ. Hangisi daha önemli? Diastolik hipertansiyon, sistolik hipertansiyon. Kardiyoloji ve aktüalite dergisi 2003; 2: 6-11.
21. Elkeles RS, Godsland IF, Feher MD, Rubens DM, Roughton M, Nugara F, Humphries SE, Richmond W, Flather M. For the PREDICT Study Group. Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes: the PREDICT study. Eur Heart J 2008; 29: 2244-51.
22. Kronmal RA, McClelland RL, Detrano R, Shea S, Lima JA, Cushman M, Bild DE, Burke GL. Risk factors for the progression of coronary artery calcification in asymptomatic subjects: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 2007; 115: 2722-30.