The Limitation in Measurement of Carotid Intima Media Thickness in Type 2 Diabetics with or without Coronary Artery Disease

제2형 당뇨병에서 관상동맥 질환 유무에 따른 경동맥 내중막 두께 측정의 한계

Background: The measurement of carotid intima-media thickness (IMT) is useful for detection of early atherosclerotic disease. But, IMT are influenced by various factors including hypertension, age, diabetes, etc. We tried to estimate the correlation between carotid IMT and coronary artery disease in diabetics. Methods: The B-mode ultrasonography and coronary angiography was perfomed in 50 as type 2 diabetes and 226 as nondiabetes. Carotid IMT was measured at around carotid bulb. Coronary artery lesions was evaluated based on quantitative coronary analysis (QCA) from coronary angiogram. Results: Type 2 diabetic group (mean age 64.5${\pm}$8.9 years old) included 21 patients without coronary artery disease and 29 patients with coronary artery disease. Non-diabetic group (mean age 61.0${\pm}$10.1) included 138 patients without coronary artery disease and 88 patients with coronary artery disease. In type 2 diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was similar to that of subjects without coronary disease (mean Rt. IMT, 1.26${\pm}$0.62 mm vs. 1.03${\pm}$0.29 mm, respectively, p=0.11, mean Lt IMT, 1.30${\pm}$0.70 mm vs. 1.17${\pm}$0.43 mm, respectively, p=0.46). But in non-diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was more than that of subjects without coronary disease, and it is statistically significant (mean Rt. IMT, 1.09${\pm}$ 0.32 mm vs. 0.96${\pm}$0.25 mm, respectively, p=0.01, mean Lt IMT, 1.19${\pm}$0.47 mm vs. 1.01${\pm}$0.32 mm, respectively, p=0.01). Conclusion: This study shows weak correlation power between carotid IMT and coronary artery diseases in diabetics, contrast to non-diabetes.