Brief report
Metabolic syndrome correlates with polyvascular lesions detected by systemic vascular ultrasonography in Japanese people with type 2 diabetes

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Abstract

Atherosclerosis is a systemic disease of blood vessels. We investigated clinical characteristics of Japanese type 2 diabetic patients with polyvascular lesions detected by systemic vascular ultrasonography. The results showed that the metabolic syndrome correlated with polyvascular lesions detected by systemic vascular ultrasonography in Japanese type 2 diabetics.

Introduction

Atherosclerosis is a systemic disease of blood vessels which in most of the cases affects several vascular beds. Accelerated polyvascular atherosclerosis is the major cause of mortality in patients with type 2 diabetes mellitus (T2DM) [1]. In particular, the early and reliable prediction of coronary artery disease (CAD) is crucial for preventing cardiovascular events in these patients. Ultrasonographic carotid intima–media thickness (IMT) has been proposed as a surrogate marker for CAD in T2DM [2]. Several biomarkers are also reported to be predictive of cardiovascular events [3]. We recently reported that: (1) systemic vascular score  2 determined by a vascular ultrasonography method for arteriosclerosis in the four arteries (abdominal aorta, carotid, renal, and common iliac arteries) was a significant marker for CAD, and (2) the performance of total systemic vascular score of ≥2 for the diagnosis of CAD was better than the mean and max intima–media thickness (IMT) [4]. Non-invasive qualitative evaluation of systemic arteriosclerosis using the vascular ultrasonography method may be useful for the early prediction of CAD in T2DM patients [4]. The aim of the present study was to clarify clinical characteristics of T2DM patients with systemic vascular score  2.

Section snippets

Materials and methods

The study (ADMIT study; UMIN 000002271) subjects were 102 consecutive Japanese patients with T2DM [males/females: 60/42, age (mean ± SD [range]): 67 ± 9 [40–85] years, body mass index (BMI): 25.7 ± 0.4 [19.1–38.5] kg/m2, duration of diabetes mellitus: 12.8 ± 0.9 [1–36] years, HbA1c (NGSP): 7.2 ± 0.1 [5.4–10.6] %], who visited the outpatient clinic of “Diabetes & Metabolic Station”, Osaka University Hospital, between September 2009 and March 2011, and subsequently underwent evaluation for systemic

Results

In the present study, the average eVFA was 134 ± 54 cm2 (40–271), and a prevalence of T2DM with the metabolic syndrome was 61% (n = 62/102). The mean circulating levels of adiponectin, S100A8/A9, hsCRP, TBARS and sCD40L were, 8.8 ± 5.3 μg/mL (2.0–38.5), 1.74 ± 1.54 μg/mL (0.27–12.52), 0.11 ± 0.14 mg/dL (0.00–0.55), 5.1 ± 0.8 nmol/mL (3.7–7.2), and 2.36 ± 0.96 pg/mL (0.13–4.66), respectively.

To clarify clinical characteristics of T2DM patients with polyvascular atherosclerotic lesions by systemic vascular

Discussion

We described here that metabolic syndrome was correlated with polyvascular atherosclerotic lesions detected by systemic vascular ultrasonography in T2DM patients. We reported that visceral fat reduction with health education improved hypoadiponectinemia [10], reduced circulating TBARS levels [11] and the number of obesity-related cardiovascular risk factors [12], and prevented cardiovascular events, in general population [13]. Measurement of not only BMI but also visceral fat area, using

Contributions

A.H. and K.K. researched and analyzed data. K.K. also participated in the concept and design of the study, interpretation of data and reviewed/edited the manuscript. H.N. and A.H.-S. recruited the patients and collected the data. T.F. and I.S. contributed to discussion and wrote the manuscript. All authors read and approved the final version of the manuscript.

Conflict of interest

We have a competing interest to declare. K.K. and T.F. are members of the “Department of Metabolism and Atherosclerosis”, a sponsored course endowed by Kowa Co. Ltd. and a company researcher is dispatched to the course. All other authors declare no competing interests.

Acknowledgments

We thank all staff at “Diabetes & Metabolic Station” for the excellent medical care, and Mrs. Miyuki Nakamura for the excellent technical assistance. This research was supported in part by a Grant-in-Aid for Scientific Research on Innovative Areas (Research in a proposed research area) “Molecular Basis and Disorders of Control of Appetite and Fat Accumulation” (#22126008, to T.F. and K.K.).

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