GFR Associated with Carotid Intima-Media Thickness

The estimated GFR, but not the stage of diabetic nephropathy graded by the urinary albumin excretion, is associated with the carotid intima-media thickness in patients with Type 2 diabetes mellitus: a cross-sectional study….

The research was done to study the relationship between the intima-media thickness (IMT) of the carotid artery and the stage of chronic kidney disease (CKD) based on the estimated glomerular filtration rate (eGFR) and diabetic nephropathy graded by the urinary albumin excretion (UAE) in patients with Type 2 diabetes mellitus.

A cross-sectional study was performed in 338 patients with Type 2 diabetes mellitus. The carotid IMT was measured using an ultrasonographic examination.

The results showed that themean carotid IMT was 1.06 +/- 0.27 mm, and 42% of the subjects showed IMT thickening ([greater than or equal to] 1.1 mm). Cerebrovascular disease and coronary heart disease were frequent in the patients with IMT thickening. The carotid IMT elevated significantly with the stage progression of CKD (0.87 +/- 0.19 mm in stage 1, 1.02 +/- 0.26 mm in stage 2, 1.11 +/- 0.26 mm in stage 3, and 1.11 +/- 0.27 mm in stage 4+5). However, the IMT was not significantly different among the various stages of diabetic nephropathy. The IMT was significantly greater in the diabetic patients with hypertension compared to those without hypertension. The IMT positively correlated with the age, the duration of diabetes mellitus, and the brachial-ankle pulse wave velocities (baPWV), and negatively correlated with the eGFR. In a stepwise multivariate regression analysis, the eGFR and the baPWV were independently associated with the carotid IMT.

The study is the first report showing a relationship between the carotid IMT and the renal parameters including eGFR and the stages of diabetic nephropathy with a confirmed association between the IMT and diabetic macroangiopathy. The study further confirms the importance of intensive examinations for the early detection of atherosclerosis and positive treatments for hypertension, dyslipidemia, obesity, as well as hyperglycemia are necessary when a reduced eGFR is found in diabetic patients.

Cardiovascular Diabetology May 15, 2010, 9:18doi:10.1186/1475-2840-9-18