Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Konstantonis Georgios
Dissertation committee:
Κωνσταντίνος Μακρυλάκης, Καθηγητής (επιβλέπων), Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Τεντολούρης, Καθηγητής , Ιατρική Σχολή, ΕΚΠΑ
Αθανάσιος Πρωτογέρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πέτρος Σφηκάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαρία Τεκτονίδου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Θεόδωρος Παπαϊωάννου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Κόκκινος, Αν. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Εκτίμηση της υποκλινικής αγγειοπάθειας με τη χρήση νεώτερων μη επεμβατικών αγγειακών βιοδεικτών σε ασθενείς με Σακχαρώδη Διαβήτη τύπου 2
Translated title:
Evaluation of subclinical arterial disease using novel non-invasive vascular biomarkers in patients with type 2 diabetes.
Summary:
Background and aims: Diabetes is associated with higher incidence of cardiovascular complications due to accelerated arterial damage. The beneficial effect of multi-factorial treatment of cardiovascular risk factors (RFs) in type 2 diabetes is well established from randomized clinical trials. We prospectively examined the impact of such a treatment in a real-world setting, on the development of subclinical arterial damage (SAD), as determined by structural/functional non-invasive biomarkers of vascular pathology (atheromatosis [presence of atheromatous plaques in carotid/femoral arteries, ankle-brachial index], carotid hypertrophy [intima-media thickness, cross-sectional wall artery area], and arteriosclerosis [carotid-femoral pulse wave velocity, carotid distensibility]).
Methods: We prospectively studied 116 persons with type 2 diabetes, treated with a multi-factorial approach of cardiovascular RFs in routine clinical practice at a tertiary medical center, and 324 individuals without diabetes, for 3.2 years. The primary outcome was changes in vascular biomarkers related to SAD.
Results: At baseline, participants in the diabetes group had higher prevalence of subclinical arterial disease. At study end, changes in clinical, biochemical and lifestyle characteristics, as well as antihypertensive and lipid-lowering treatments, were comparable between the two groups. During follow-up, classical cardiovascular RFs (smoking, blood pressure, LDL-cholesterol, triglycerides), and behavioral features were significantly improved in both groups. Multivariate analysis, after adjusting for all classical cardiovascular RFs and use of anti-hypertensive/lipid-lowering therapies, demonstrated that all evaluated SAD biomarkers were similarly changed between the two groups.
Conclusions: Implementation of a multi-modality approach of type 2 diabetes treatment is feasible and efficacious in decelerating progression rates of SAD in routine clinical practice.
Main subject category:
Health Sciences
Keywords:
Τype 2 diabetes, Μulti-factorial treatment, Subclinical arterial disease, Vascular biomarkers, Cardiovascular risk.
Number of references:
148
