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Exp Clin Endocrinol Diabetes 2021; 129(10): 750-756
DOI: 10.1055/a-1107-2657
Article

Carotid Intima-Media Thickness is a Predictor of Subclinical Myocardial Damage in Men with Type 2 Diabetes Mellitus

Sebastian Hörber
1   Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Germany
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
,
Angela Lehn-Stefan
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
,
Anja Hieronimus
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
4   Department of Internal Medicine IV, Division of Endocrinology and Diabetology, Nephrology University Hospital of Tübingen, Germany
,
Sarah Hudak
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
4   Department of Internal Medicine IV, Division of Endocrinology and Diabetology, Nephrology University Hospital of Tübingen, Germany
,
Louise Fritsche
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
4   Department of Internal Medicine IV, Division of Endocrinology and Diabetology, Nephrology University Hospital of Tübingen, Germany
,
Andreas Fritsche 
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
4   Department of Internal Medicine IV, Division of Endocrinology and Diabetology, Nephrology University Hospital of Tübingen, Germany
,
Martin Heni
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
4   Department of Internal Medicine IV, Division of Endocrinology and Diabetology, Nephrology University Hospital of Tübingen, Germany
,
Hans-Ulrich Häring
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
4   Department of Internal Medicine IV, Division of Endocrinology and Diabetology, Nephrology University Hospital of Tübingen, Germany
,
Andreas Peter
1   Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Germany
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
,
Elko Randrianarisoa
2   Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany
3   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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Abstract

Background Type 2 diabetes mellitus (T2DM) promotes the development of atherosclerosis and is a major risk factor for cardiovascular disease. High-sensitivity cardiac troponin I (hs-cTnI) assays fundamentally improved the diagnosis of myocardial injury and even enable the prediction of future cardiovascular events in the general population. However, data about the association of hs-cTnI with cardiovascular risk factors and carotid intima media thickness (cIMT) as a marker of atherosclerosis are limited, especially in patients with T2DM.

Methods In this cross-sectional study we analyzed clinical and laboratory parameters of 234 patients (43% women) with T2DM and a median age of 65 years (interquartile range: 57–71). The median duration of diabetes mellitus was 10 years (6–17). Anthropometric data, blood pressure, glycemic parameters and lipid profiles were determined. Hs-cTnI plasma concentrations were measured on an ADVIA Centaur XPT immunoassay analyzer and cIMT was evaluated by high-resolution ultrasound.

Results Hs-cTnI plasma concentrations were below the gender-specific 99th  percentile in 93% of T2DM patients with a median concentration of 4.0 ng/l (interquartile range: 2.0–10.0). Hs-cTnI was significantly associated with gender, renal function and C-reactive protein in the entire study cohort. Gender-specific analyses revealed cIMT and renal function to be significantly associated with hs-cTnI in men. Contrary, only age was significantly associated with hs-cTnI in women.

Conclusion In a real-world clinical setting in patients with T2DM, cIMT is a predictor of subclinical myocardial damage in men, but not in women.

Key words

High-sensitivity cardiac troponin I - type 2 diabetes mellitus - intima-media thickness, cardiovascular disease


Publikationsverlauf

Eingereicht: 23. Oktober 2019
Eingereicht: 08. Januar 2020

Angenommen: 27. Januar 2020

Artikel online veröffentlicht:
04. März 2020

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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