Impact of type 2 diabetes mellitus on diffuse inflammatory activation of de novo atheromatous lesions: Implications for systemic inflammation

作者：Toutouzas K^*; Tsiamis E; Drakopoulou M; Synetos A; Karampelas J; Riga M; Tsioufis C; Tousoulis D; Stefanadi E; Vlassis C; Stefanadis C

来源：Diabetes & Metabolism, 2009, 35(4): 299-304.

DOI：10.1016/j.diabet.2009.01.005

• Diabetes mellitus
• Inflammation
• Atherosclerosis
• Intracoronary thermography
• CRP

Aims. - Local coronary and systemic inflammation is pronounced in patients with diabetes mellitus (DM). Intracoronary thermography detects local inflammation and C-reactive protein (CRP) is a marker of systemic inflammation. We investigated whether or not, in patients with DM. thermal heterogeneity of culprit lesions (CLs) correlates with that of non-culprit lesions (NCLs) and with systemic inflammation.
Methods. - We included DM patients who had two angiographically significant lesions and were undergoing percutaneous coronary intervention. We measured the temperature difference (AT) between the lesion and proximal vessel wall.
Results. - We included 104 (n = 208 lesions) patients: 32 (n = 64 lesions) had DM and 72 (n = 144 lesions) were non-DM (control group). Delta T was increased in DM in both CLs and NCLs (CLs: DM = 0.12 +/- 0.06 degrees C; no DM = 0.06 +/- 0.04 degrees C; P < 0.01 versus NCLs: DM = 0.13 +/- 0.08 degrees C versus no DM = 0.06 +/- 0.05 degrees C; P < 0.01). Patients with DM had similar Delta T in CLs and NCLs (P = 0.49). A linear correlation was detected between heat production in all lesions and CRP (R=0.45; P<0.01), which was attributed to the correlation of Delta T in lesions of patients with DM and CRP (R = 0.32; P < 0.01). In lesions of patients with low CRP, a greater rate of discrepancy was found, as 100% of lesions in patients with DM versus 66.1% of lesions of patients without DM had a high Delta T in one or both lesions (P < 0.01).
Conclusion. - In patients with DM, local inflammatory activation is diffuse and correlates with systemic inflammation. However, low systemic inflammatory activation does not always predict an increase in local thermal heterogeneity.

• 出版日期2009-9