الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus often simply referred to as diabetes; is a group of
metabolic diseases in which a person has high blood sugar, either because
the body does not produce enough insulin, or because cells do not respond
to the insulin that is produced.
Intima media thickness of the carotid arteries (cIMT) is a validated
surrogate marker of early atherosclerosis and is associated with coronary
atherosclerosis and with the risk of future vascular events. Because it can
be measured relatively simply and noninvasively, it is well suited for use
in large-scale population studies.
The important role of long-term hyperglycemia in the development of
atherosclerosis is known and a correlation between HbA1c and cIMT was
demonstrated especially in women and in children affected by type 1
diabetes.
The accurate monitoring in critical patients, such as the patients with
type 2 diabetes, is crucial since persons with diabetes have 2–6 folds higher
cardiovascular risk than subjects without diabetes. Male gender was also
associated to a more rapid increase of cIMT even in type 2 diabetes, thus
further increasing the need for accurate measurement and monitoring.
So, this study aimed to investigate the relation between carotid intimal
medial thickness and HbA1c with the severity of coronary artery disease
in diabetic patients.
To elucidate our results, this was a prospective comparative study
carried out on 160 diabetic patients diagnosed with ischemic heart disease
recruited from cardiology department in Menoufia university Hospital
during the period from September 2019 to March 2021.
All patients included in this study were subjected to the following: Full
history taking included: Personal history: name, age, sex. Past history:
Summary
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Any medical disease and its nature, duration, treatment and any drug intake
and its regimen and duration of intake. Family history: of any similar
condition. Medical history taking: presence of HTN, DM and dyslipidemia.
General examination: pulse, blood pressure, temperature and respiratory
rate, etc. Local examination: examination of the heart to detect abnormal
sounds or murmur. Laboratory investigations including: Lipid profile,
HbA1C, CBC, INR, serum creatinine and liver function test.
Results of this study can be summarized as follows:
A total of 160 patients included in this study, the mean age, weight,
hight, BMI and duration of DM of the studied patients were
(43.35±17.88, 64.70±8.89, 167.94±9.34, 23.15±4.04 and 4.54±2.92),
respectively. Most of the studied patients (64.4%) were males.
Our patients were classified into 3 groups according to CIMT; Group
I (cIMT <0.8) included 56 patients (35%), group II (cIMT, 0.8-1)
included 59 patients (43.2%) and group III (cIMT >1.01) included 35
patients (21.9%).
The studied patients were further classified according to Gensini score
into 3 groups; group A included 46 patients (28.75%) with low
Gensini score, group B included 49 patients (43.2%) with moderate
Gensini score and group C included 65 patients (30.65%) with high
Gensini score.
CIMT was significant higher in patients with high Gensini score than
other groups (p value <0.05).
There was a significant positive correlation between HbA1C and
CIMT and both total cholesterol & LDL levels (p value< 0.05).
HbA1C (9.92) and CIMT (1.5) were cut values to predict high Gensini
score with sensitivity 71.8%, 80.2%, respectively and specificity
68.01, 70.91, respectively.
Conclusions
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CONCLUSIONS
Our study concluded that there was a significant positive correlation
between CIMT and HbA1C in diabetic patients and both of them were
significantly elevated in diabetic patients with severe CAD measured with
Gensini score.