Iranian Journal of Diabetes and Obesity

Objective: Atherosclerosis disease, inflammation and malnutrition have strong association with end stage renal disease (ESRD). Diabetes mellitus (DM) is the most commonly ESRD causes. Diabetic nephropathy (DN) could be associated with inflammation. Type 2 diabetic patients with advanced nephropathy show the highest levels of inflammatory markers. This study was designed to determine the association between malnutrition–inflammation–atherosclerosis (MIA complex) in Diabetic patients with peritoneal dialysis.

Materials and Methods: Fifty seven diabetic patients on peritoneal dialysis were investigated and demographic variables (age, gender, BMI and dialysis duration), Inflammatory markers (cholesterol, Albumin and CRP) were measured in routine protocol. CIMT (Carotid Intima-Media Thickness) and plaque number were evaluated by B-Mode ultrasonography (7.5 -10 MHZ probe) in supine position.

Results: the mean age (Standard deviation) of patients was 51±17.3 years. The mean time on dialysis was 26.12 ±25.42 (range 4–120) months. The mean of IMT was 5.98±1.17 mm and mean of plaques were 1.80±2.01. Results of Analysis of variance (ANOVA) showed that older patients have more carotid plaques (P-Value= 0.000). There was a significant relation between serum albumin and number of plaques (P-Value=0.043). CIMT and number of plaque revealed significant correlation with age, serum albumin and dialysis duration (P<0.05).

Conclusion: Our findings showed, in diabetic patients on peritoneal dialysis, carotid atherosclerosis (CIMT and Number of plaque) is associated with some inflammation, malnutrition markers.

Objective: Duplex ultrasonography is a non-invasive, non-expensive screening test for carotid disease. Intima media thickness (IMT) is appropriate for atherosclerosis process diagnosis. Leukoaraisis (LA) increase the risk of cerebrovascular accident (CVA). LA patients need preventive medication for CVA. IMT is a non-invasive diagnostic and prognostic test in LA. The aim of this study was evaluate the carotid IMT and LA in diabetic patients as atherosclerosis surrogate marker.

Materials and Methods: The case-control study was done on 100 diabetic patients and 100 controls. They were selected by simple sampling method in Shaheed Sadoughi MRI unit. Two groups member were matched by age and sex. The patient’s information (age, sex, weight, height, past medical history, smoking history, ischemic heart disease(IHD), CVA and past medication) according the study checklist was collected. All statistical analysis was done by SPSS21.

Results Totally 200 patients were studied, 102 in normal group and 98 in diabetic group. The mean age of patients was 64.39 (±9.12) and 47% participants were male. There were no statistical differences between hypertension and hyperlipidemia frequency in two groups (P-value>0.05). The mean of left CIMT was 0.856 (±0.202) in normal and 0.962 (±171) in diabetics groups (P-value: 0.026). The mean of right CIMT was 0.853 (±0.215) in normal and 0.973 (±188) in diabetics groups (P-value: 0.024). The LA was significantly more prevalent in diabetic patients (P-value:0.001).

Conclusion: LA increases the risk of CVA and dementia. The LA pathology is unknown. The epidemiological studies revealed the age, diabetes, smoking and atherosclerosis are related with LA. Our findings showed that CIMT as an atherosclerosis marker was higher in LA patients than control group.