Generalized Vascular Damage Including Glomerular Dysfunction in Newly-Detected Type 2 Diabetic Patients
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Hamdy Abo-Zenah 1 * , Moharram M. 2, Imran A. 3, Quazalbash S. 3, Al-Benayan A. 4, Sabry A. 5
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1 King Abdulaziz Naval Base-Armed Forces Hospital, Department of Internal Medicine, Jubail, Saudi Arabia2 King Abdulaziz Naval Base-Armed Forces Hospital, Department of Radiology, Jubail, Saudi Arabia3 King Abdulaziz Naval Base-Armed Forces Hospital, Department of Ophthalmology, Jubail, Saudi Arabia4 King Abdulaziz Naval Base-Armed Forces Hospital, Department of Medical Administration, Jubail, Saudi Arabia5 In Collaboration with Prince Salman Nephrology Center, Saudi Arabia* Corresponding Author

Abstract

Aim: Diabetes mellitus (DM) is considered a vascular disease, we intended to determine prevalence and nature of generalized and glomerular vascular abnormalities the moment it is diagnosed (ND-DM) in a cohort of patients with Arabic descent. Over 9 months, 216 out of 1208 asymptomatic Saudies were referred by the Primary Care Physicians on having risk factors for future development of DM for DM screening. Methods: For the 54 ND-DM patients and 18 non-diabetic controls, clinical examination including body mass index (BMI) and waist:hip ratio (WHR), ultrasound determination of common carotid artery (CCA) intimal-medial thickness (IMT), hemoglobin A1C (A1C), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), CRP, albuminuria, serum creatinine (sCr), and glomerular filtration rate (eGFR) were done. Results: About 4.5% were unaware of their diabetes and they had significant (35/54 vs 5/18 p=0.01) preclinical atherosclerosis (increased IMT and/or atheromatous plaques) with similar age, HDL-C, CRP and eGFR compared to controls. Also, they had pathologic microalbuminuria ([μA] 145.4±201.4 vs 18.9±7.1, p=0.013) with higher BMI (29.5±3.6 vs 27.2±1.8, p=0.043), WHR (0.94±0.12 vs 0.79±0.1, p=0.001), TC (5.1±0.9 vs 3.8±0.6, p=0.001) and TG (2.3±0.9 vs 1.2±0.4, p=0.001) compared to controls. Diabetic nephropathy (DN), as inferred from glomerular damage marker μA was significantly prevalent (17/54, p=0.014) in ND-DM patients. Those with DN had more IMT (0.96±0.1 vs 0.77±0.1, p=0.0001), WHR (0.98±0.1 vs 0.91±0.13, p=0.037), TC (5.4±0.7 vs 4.9±0.9, p=0.049) and TG (2.7±0.4 vs 2.02±0.4, p=0.012), lower eGFR (86.4±12 vs 104.1±13, p=0.0001), older age (40.9±5 vs 37.9±4, p=0.028) and worse glycamic control (A1C=8.1±1.6 vs 7.3±1.5, p=0.048). Also, diabetic retinopathy (DR) was significantly prevalent (n=19) in ND-DM patients (p=0.047). Interestingly, DN and DR, were significantly correlated with each other (r=0.841, p=0.0001) and with IMT (r=0.38, p=0.005 and r=0.35, p=0.009, respectively). Conclusion: The newly-detected Saudi diabetics already had more vascular changes including glomerular damage than normal glucose-tolerant subjects with clustering of risk factors in particular abdominal obesity, and dyslipidaemia.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

EUR J GEN MED, Volume 6, Issue 1, January 2009, 28-37

https://doi.org/10.29333/ejgm/82633

Publication date: 15 Jan 2009

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