CLINICAL EVALUATION OF RISK FACTORS FOR CAROTID ATHEROSCLEROSIS IN PATIENTS WITH TYPE 2 DIABETES COMPLICATED WITH CHRONIC KIDNEY DISEASE

THE AIM: to assess the additive effects of dyslipidemia, hypertension and decreased GFR (<60 ml/min/1.73m2) on the characteristics of carotid atherosclerosis in patients with type 2 diabetes (DT2) and CKD stages 1-3. PATIENTS AND METHODS. We investigated 100 patients with DT2 and CKD stages 1-3 aged 56.54±12.17 years. Control group included 26 healthy subjects of the same age. Total plaque area (TPA) was calculated as the sum of all plaque areas. GFR was estimated by CKI-EPI equation. RESULTS. We divided patients with DT2 and CKD into 3 groups: group 1 (n=26) - without additional risk factors for atherosclerosis, group 2 (n=28) - with 1 additional risk factor and group 3 (n=46) - with 2-3 additional risk factors. The prevalence of carotid atherosclerotic plaques was 8% in group 1, 21% in group 2 and 28% in group 3 (p<0.05). We found a significant difference in IMT between left and right carotid artery (0.70±0.16 mm versus 0.66±0.13 mm, p<0.001, respectively). However, there was no significant difference in carotid IMT between patients with plagues and without them (p=0.171). CONCLUSION. The results of the study suggest that dyslipidemia, hypertension and decreased GFR have additive effects on the development of carotid atherosclerosis in patients with DT2 and CKD stages 1-3.

diabetes mellitus, chronic kidney disease, diabetic nephropathy, atherosclerosis, dyslipidemia, hypertension, intima-media thickness

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