Diabetes mellitus type 2 (DM2) presents an extreme risk for macro- and microangiopathy. The aim was to estimate the relationship between macro- and microangiopathy complications of DM2 and the posibility to predict the non-manifest macro- and microangiopathy in these patients. The study group of 415 DM2 followed in our outpatient clinic ( 218 males, 197 females, p NS) was divided in 2 groups – with manifested macroangiopathy (n = 112, MMC+) and without it (n= 303, MMC- ). The patients´ history, antropometric and laboratory data were ascertained from the patients´ medical records. The MMC+ group was significantly older than the MMC- group (69,6±6,3 vs. 63,9±9,8y, p <0,001) and the duration of DM2, arterial hypertension and dyslipidaemia was significantly (p <0,01) longer. There was no difference in smoking habits, systolic blood pressure, BMI, waist circumference, DM2 compensation, LDL and total cholesterol, triglycerides and proteinuria. Serum creatinine (119.9±11,1 vs 109.5 ±24.9 , p <0,001 ) and urea (7.3±3,5 vs 6.4±2.3, p <0,001) were higher in the MMC+ group, HDL cholesterol (1.10±0.24 vs 1.16 0.24, p <0,05) and Apo-A (1.20±0.23 vs 1.30 ±0.28, p <0,01) were lower. In the MMC+ group, more patiens suffered from the diabetic foot (11% vs 3%, p <0,05), nefropathy (29% vs 9%, p <0,001) and neuropathy (33% vs 19%, p <0,05). The was no difference in cardiovascular and antidiabetic medication between the groups, except aspirin and betablockers. The results suggest the level of plasma creatinine and urea, apolipoprotein A and HDL cholesterol can be predictive for the presence of macro- and microangiopathy in DM2. Those with macroangiopathy are supposed to have more often microangiopathy than the patients without it. Age and duration of DM2 and hypertension are the major predictive factors for vascular complications.
Supported by grant IGA MZ ČR CZ 8279-3 (2005-2007)