- Miscellaneous
- Quality Matters as Much as Quantity of Skeletal Muscle: Clinical Implications of Myosteatosis in Cardiometabolic Health
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Hong-Kyu Kim, Chul-Hee Kim
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Endocrinol Metab. 2021;36(6):1161-1174. Published online December 28, 2021
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DOI: https://doi.org/10.3803/EnM.2021.1348
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- Although age-related changes in skeletal muscles are closely associated with decreases in muscle strength and functional decline, their associations with cardiometabolic diseases in the literature are inconsistent. Such inconsistency could be explained by the fact that muscle quality—which is closely associated with fatty infiltration of the muscle (i.e., myosteatosis)—is as important as muscle quantity in cardiometabolic health. However, muscle quality has been less explored compared with muscle mass. Moreover, the standard definition of myosteatosis and its assessment methods have not been established yet. Recently, some techniques using single axial computed tomography (CT) images have been introduced and utilized in many studies, as the mass and quality of abdominal muscles could be measured opportunistically on abdominal CT scans obtained during routine clinical care. Yet, the mechanisms by which myosteatosis affect metabolic and cardiovascular health remain largely unknown. In this review, we explore the recent advances in the assessment of myosteatosis and its changes associated with aging. We also review the recent literature on the clinical implication of myosteatosis by focusing on metabolic and cardiovascular diseases. Finally, we discuss the challenges and unanswered questions that need addressing to set myosteatosis as a therapeutic target for the prevention or treatment of cardiometabolic diseases.
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- Clinical Study
- Relationship of Sarcopenia with Microcirculation Measured by Skin Perfusion Pressure in Patients with Type 2 Diabetes
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Chan-Hee Jung, Yoon Young Cho, Dughyun Choi, Bo-Yeon Kim, Chul-Hee Kim, Ji-Oh Mok
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Endocrinol Metab. 2020;35(3):578-586. Published online September 22, 2020
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DOI: https://doi.org/10.3803/EnM.2020.679
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Abstract
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- Background
Few studies have examined the relationship of sarcopenia with the microcirculation. The current study investigated the relationship of sarcopenia with microcirculatory function, as assessed by skin perfusion pressure (SPP), in type 2 diabetes mellitus (T2DM) patients.
Methods In total, 102 T2DM patients who underwent SPP measurements and bioelectrical impedance analysis (BIA) were enrolled in this cross-sectional study. SPP was assessed using the laser Doppler technique. Sarcopenia was defined as low height-adjusted appendicular muscle mass (men, <7 kg/m2; women, <5.7 kg/m2) using BIA. We divided the participants into two groups based on SPP (≤50 and >50 mm Hg), and an SPP below 50 mm Hg was considered to reflect impaired microcirculation.
Results Fourteen patients (13.7%) were diagnosed with impaired microcirculatory function of the lower limb based on SPP. The prevalence of sarcopenia in all subjects was 11.8%, but the percentage of patients with an SPP ≤50 mm Hg who had sarcopenia was more than triple that of patients with an SPP >50 mm Hg (28.6% vs. 9.1%, P=0.036). A significant positive correlation was found between SPP and appendicular muscle mass adjusted for height (P=0.041 for right-sided SPP). Multiple logistic regression analysis showed that patients with sarcopenia had an odds ratio of 4.1 (95% confidence interval, 1.01 to 24.9) for having an SPP ≤50 mm Hg even after adjustment for confounding factors.
Conclusion These results suggest that sarcopenia may be significantly associated with impaired microcirculation in patients with T2DM. Nonetheless, the small number of patients and wide CI require cautious interpretation of the results.
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Citations
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- Preclinical study of diabetic foot ulcers: From pathogenesis to vivo/vitro models and clinical therapeutic transformation
Yuqing Du, Jie Wang, Weijing Fan, Renyan Huang, Hongfei Wang, Guobin Liu International Wound Journal.2023; 20(10): 4394. CrossRef - Bioelectrical Impedance Analysis for the Assessment of Body Composition in Sarcopenia and Type 2 Diabetes
Stefano Sbrignadello, Christian Göbl, Andrea Tura Nutrients.2022; 14(9): 1864. CrossRef - Discrimination between possible sarcopenia and metabolic syndrome using the arterial pulse spectrum and machine-learning analysis
Li-Wei Wu, Te OuYoung, Yu-Chih Chiu, Ho-Feng Hsieh, Hsin Hsiu Scientific Reports.2022;[Epub] CrossRef - The prevalence and risk factors of sarcopenia in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Yaqin Ai, Ruoxin Xu, Lingping Liu Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef
- Clinical Study
- Effect of Dapagliflozin on Alanine Aminotransferase Improvement in Type 2 Diabetes Mellitus with Non-alcoholic Fatty Liver Disease
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Dug-Hyun Choi, Chan-Hee Jung, Ji-Oh Mok, Chul-Hee Kim, Sung-Koo Kang, Bo-Yeon Kim
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Endocrinol Metab. 2018;33(3):387-394. Published online September 18, 2018
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DOI: https://doi.org/10.3803/EnM.2018.33.3.387
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- Background
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are expected to improve the liver function of patients with non-alcoholic fatty liver disease (NAFLD) combined type 2 diabetes mellitus (T2DM) by its characteristic mechanism. This study was designed to investigate the effect of dapagliflozin, one of the SGLT2i, on the liver function of T2DM with NAFLD when combined with metformin. MethodsAmong patients who received dual oral hypoglycemic agents within the 3 months of diagnosing NAFLD, patients who had abnormal alanine aminotransferase (ALT) level (>40 IU/L) were included. Patients were divided into two groups: metformin+dapagliflozin group and metformin+dipeptidyl peptidase-4 inhibitors (DPP4i) group. Demographic data, biochemical data and the clinical and treatment histories of all patients were reviewed. ResultsA total of 102 patients were included (dapagliflozin group, n=50; DPP4i group, n=52). Dapagliflozin group showed more weight loss and more ALT decline than DPP4i group (−2.9 kg vs. −0.4 kg, P=0.005; −21.1 U/L vs. −9.5 U/L, P=0.008, respectively) and the proportion of patients with ALT normalization after treatment was also significantly higher in the dapagliflozin group (80.0% vs. 61.5%, P=0.041). The effect of dapagliflozin with metformin on ALT normalization remained significant after adjustment for confounding variables including body weight loss (odds ratio, 3.489; P=0.046). ConclusionALT improvement was statistically significant in the dapagliflozin than the DPP4i when combined with metformin and the result was consistent after adjustment for confounding variables including body weight loss.
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- Obesity and Metabolism
- Serum Concentrations of Ghrelin and Leptin according to Thyroid Hormone Condition, and Their Correlations with Insulin Resistance
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Kyu-Jin Kim, Bo-Yeon Kim, Ji-Oh Mok, Chul-Hee Kim, Sung-Koo Kang, Chan-Hee Jung
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Endocrinol Metab. 2015;30(3):318-325. Published online May 18, 2015
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DOI: https://doi.org/10.3803/EnM.2015.30.3.318
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- Background
Thyroid hormones can influence energy metabolism and insulin sensitivity via their interaction with adipocytokines and gut hormones. The aims of this study were to evaluate differences in serum ghrelin and leptin concentrations according to thyroid hormone levels, and to investigate the correlation of insulin resistance. MethodsA total of 154 patients (57 hyperthyroid patients, 61 euthyroid patients, and 36 hypothyroid patients; mean age, 47.9 years) were enrolled. Serum leptin, ghrelin, and insulin levels were measured and insulin resistance was calculated using the formula of the homeostasis model assessment of insulin resistance (HOMA-IR). ResultsThere were no differences in mean concentrations of ghrelin or leptin among the three groups. There were no significant differences in insulin levels between the groups (P=0.06), although hyperthyroid patients had borderline statistically significantly higher levels of insulin than did euthyroid subjects by post hoc test (26.4 µIU/mL vs. 16.1 µIU/mL, P=0.057). Regarding HOMA-IR index, the mean levels were highest in the hyperthyroid group among those of the three groups (hyperthyroid vs. euthyroid vs. hypothyroid, 6.7 vs. 3.8 vs. 4.4, P=0.068). Plasma levels of ghrelin were significantly negatively correlated with age, insulin, glucose, body mass index (BMI), and HOMA-IR. Plasma levels of leptin showed significant positive correlation with BMI and triglyceride. There were no significant correlations among thyroid hormone, thyrotropin, ghrelin, leptin, or insulin. ConclusionThe present study found that serum ghrelin, leptin, and insulin levels didn't differ according to thyroid function conditions. Further studies with larger numbers of patients are required to establish a direct relationship between plasma ghrelin, leptin, and thyroid hormone.
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Citations
Citations to this article as recorded by 
- Thyroid disorders and gastrointestinal dysmotility: an old association
Guang-Meng Xu, Ming-Xin Hu, Si-Yu Li, Xuan Ran, Hao Zhang, Xiang-Fu Ding Frontiers in Physiology.2024;[Epub] CrossRef - Insulin resistance, leptin and adiponectin in lean and hypothyroid children and adolescents with obesity
Doaa El Amrousy, Dalia El-Afify, Shaimaa Salah BMC Pediatrics.2022;[Epub] CrossRef - Mediators of energy homeostasis in hyperthyroidism
Avinash Patil, Suresh Vaikkakara, Mani Deepthi Dasari, Sandeep Ganta, Alok Sachan, Kiranmayi S. Vinapamula Archives of Endocrinology and Metabolism.2022;[Epub] CrossRef - STUDY OF GHRELIN LEVELS IN HYPOTHYROID PATIENTS BEFORE AND AFTER
TREATMENT
Peeyush Yadav, G. G. Kaushik INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2021; : 52. CrossRef - Acylated Ghrelin Attenuates l-Thyroxin–induced Cardiac Damage in Rats by Antioxidant and Anti-inflammatory Effects and Downregulating Components of the Cardiac Renin–angiotensin System
Rehab Badi Journal of Cardiovascular Pharmacology.2021; 78(3): 422. CrossRef - Experimental hypothyroidism in adult male rats: the effects of Artemisia dracunculus aqueous extract on serum thyroid hormones, lipid profile, leptin, adiponectin, and antioxidant factors
Mohammad Mohsen Mohammadi, Mahdi Saeb, Saeed Nazifi Comparative Clinical Pathology.2020; 29(2): 485. CrossRef - Leptin, neuropeptide Y (NPY), melatonin and zinc levels in experimental hypothyroidism and hyperthyroidism: relation with melatonin and the pineal gland
Abdulkerim Kasım Baltaci, Rasim Mogulkoc Hormone Molecular Biology and Clinical Investigation.2018;[Epub] CrossRef - Leptin, NPY, Melatonin and Zinc Levels in Experimental Hypothyroidism and Hyperthyroidism: The Relation to Zinc
Abdulkerim Kasım Baltaci, Rasim Mogulkoc Biochemical Genetics.2017; 55(3): 223. CrossRef - Thyroid Hormone Regulation and Insulin Resistance: Insights From Animals Naturally Adapted to Fasting
Bridget Martinez, Rudy M. Ortiz Physiology.2017; 32(2): 141. CrossRef - Role of the Orexin System on the Hypothalamus-Pituitary-Thyroid Axis
Antonietta Messina, Carolina De Fusco, Vincenzo Monda, Maria Esposito, Fiorenzo Moscatelli, Anna Valenzano, Marco Carotenuto, Emanuela Viggiano, Sergio Chieffi, Vincenzo De Luca, Giuseppe Cibelli, Marcellino Monda, Giovanni Messina Frontiers in Neural Circuits.2016;[Epub] CrossRef - Serum Concentrations of Ghrelin and Leptin according to Thyroid Hormone Condition, and Their Correlations with Insulin Resistance (Endocrinol Metab2015;30:318-25, Kyu-Jin Kim et al.)
Jin Hwa Kim Endocrinology and Metabolism.2015; 30(4): 631. CrossRef - Serum Concentrations of Ghrelin and Leptin according to Thyroid Hormone Condition, and Their Correlations with Insulin Resistance (Endocrinol Metab2015;30:318-25, Kyu-Jin Kim et al.)
Chan-Hee Jung Endocrinology and Metabolism.2015; 30(4): 633. CrossRef
- Adrenal gland
- Clinical Characteristics and Metabolic Features of Patients with Adrenal Incidentalomas with or without Subclinical Cushing's Syndrome
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Bo-Yeon Kim, A-Reum Chun, Kyu-Jin Kim, Chan-Hee Jung, Sung Koo Kang, Ji-Oh Mok, Chul-Hee Kim
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Endocrinol Metab. 2014;29(4):457-463. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.457
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- Background
The aim of this study was to examine the clinical characteristics of adrenal incidentalomas discovered by computed tomography (CT) and to investigate metabolic features of subclinical Cushing's syndrome (SCS) in patients with adrenal incidentalomas in a tertiary hospital in Korea. MethodsThis retrospective study examined the clinical aspects of 268 patients with adrenal incidentalomas discovered by CT at Soonchunhyang University Bucheon Hospital. Clinical data and endocrine function of the patients as well as histological findings were obtained from medical records, while anatomic characteristics were analyzed by reviewing imaging studies. Hormonal tests for pheochromocytoma, Cushing's syndrome, and aldosterone-secreting adenoma were performed. ResultsMost (n=218, 81.3%) cases were nonfunctioning tumors. Of the 50 patients with functioning tumors (18.7%), 19 (7.1%) were diagnosed with SCS, nine (3.4%) with overt Cushing's syndrome, 12 (4.5%) with primary aldosteronism, and 10 (3.7%) with pheochromocytoma. Malignant tumors (both primary and metastatic) were rare (n=2, 0.7%). Body mass index, fasting glucose, hemoglobin A1c, and total cholesterol were significantly higher in patients with SCS in comparison with those with nonfunctioning tumors. The prevalence of type 2 diabetes mellitus and hypertension were significantly higher in patients with SCS compared with those with nonfunctioning tumors. ConclusionFunctioning tumors, especially those with subclinical cortisol excess, are commonly found in patients with adrenal incidentalomas, although malignancy is rare. In addition, patients with SCS in adrenal incidentalomas have adverse metabolic and cardiovascular profiles.
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Yasin Arac, Guzin F Yaylali, Senay Topsakal, Canay Onder Cureus.2024;[Epub] CrossRef - Management of Adrenal Cortical Adenomas: Assessment of Bone Status in Patients with (Non-Functioning) Adrenal Incidentalomas
Alexandra-Ioana Trandafir, Mihaela Stanciu, Simona Elena Albu, Vasile Razvan Stoian, Irina Ciofu, Cristian Persu, Claudiu Nistor, Mara Carsote Journal of Clinical Medicine.2023; 12(13): 4244. CrossRef - Adrenalectomy improves blood pressure control in nonfunctioning adrenal incidentalomas and glycemic and lipid control in patients with autonomous cortisol secretion
Marta Araujo-Castro, César Mínguez Ojeda, María Noelia Sánchez Ramírez, Victoria Gómez Dos Santos, Eider Pascual-Corrrales, María Fernández-Argüeso Endocrine.2022; 78(1): 142. CrossRef - Depression was associated with younger age, female sex, obesity, smoking, and physical inactivity, in 1027 patients with newly diagnosed type 2 diabetes: a Swedish multicentre cross-sectional study
Eva O. Melin, Pär Wanby, Thomas Neumark, Sara Holmberg, Ann-Sofi Nilsson Neumark, Karin Johansson, Mona Landin-Olsson, Hans Thulesius, Magnus Hillman, Maria Thunander BMC Endocrine Disorders.2022;[Epub] CrossRef - Metabolic syndrome and Visceral Adiposity Index in non-functional adrenal adenomas
Savas Karatas, Yalcin Hacioglu, Selvihan Beysel Archives of Endocrinology and Metabolism.2022;[Epub] CrossRef - DHEAS and Differential Blood Counts as Indirect Signs of
Glucocorticoid Excess in Adrenal Non-Producing Adenomas
Eliza P. Winzinger, Hana Jandikova, Matthias Haase, Andreas Knauerhase, Tudor Winzinger, Matthias Schott, Holger S. Willenberg Hormone and Metabolic Research.2021; 53(08): 512. CrossRef - Links between aldosterone excess and metabolic complications: A comprehensive review
C. Bothou, F. Beuschlein, A. Spyroglou Diabetes & Metabolism.2020; 46(1): 1. CrossRef - Presentation and outcome of patients with an adrenal mass: A retrospective observational study
Nadeema Rafiq, Tauseef Nabi, SajadAhmad Dar, Shahnawaz Rasool Clinical Cancer Investigation Journal.2020; 9(5): 198. CrossRef - Malignancy Risk and Hormonal Activity of Adrenal Incidentalomas in a Large Cohort of Patients from a Single Tertiary Reference Center
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Nataša Vujačić, Ivan Paunović, Aleksandar Diklić, Vladan Živaljević, Nikola Slijepčević, Nevena Kalezić, Mirjana Stojković, Miloš Stojanović, Biljana Beleslin, Miloš Žarković, Jasmina Ćirić Journal of Medical Biochemistry.2019;[Epub] CrossRef - The association of low muscle mass with soluble receptor for advanced glycation end products (sRAGE): The Korean Sarcopenic Obesity Study (KSOS)
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Emanuela M. Ribeiro Cavalari, Marcela P. de Paula, Mariana Arruda, Nathália Carraro, Arthur Martins, Kamila de Souza, Maria C. Coelho, Nathalie Anne de Oliveira e Silva de Morais, Aline B. Moraes, Leonardo Vieira Neto Clinical Endocrinology.2018; 89(5): 586. CrossRef - Guidelines for the Management of Adrenal Incidentaloma: the Korean Endocrine Society, Committee of Clinical Practice Guidelines
Jung-Min Lee, Mee Kyoung Kim, Seung-Hyun Ko, Jung-Min Koh, Bo-Yeon Kim, Sang-Wan Kim, Soo-Kyung Kim, Hae-Jin Kim, Ohk-Hyun Ryu, Juri Park, Jung-Soo Lim, Seong Yeon Kim, Young Kee Shong, Soon Jib Yoo The Korean Journal of Medicine.2017; 92(1): 4. CrossRef - Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management
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Jung-Min Lee, Mee Kyoung Kim, Seung-Hyun Ko, Jung-Min Koh, Bo-Yeon Kim, Sang Wan Kim, Soo-Kyung Kim, Hae Jin Kim, Ohk-Hyun Ryu, Juri Park, Jung Soo Lim, Seong Yeon Kim, Young Kee Shong, Soon Jib Yoo Endocrinology and Metabolism.2017; 32(2): 200. CrossRef - Increased 3β-hydroxysteroid dehydrogenase 2 and 17α-hydroxylase activities in a virilized adolescent female with adrenal adenoma: A case report
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Guido Di Dalmazi, Renato Pasquali, Felix Beuschlein, Martin Reincke European Journal of Endocrinology.2015; 173(4): M61. CrossRef - Metabolic comorbidities in Cushing's syndrome
Francesco Ferraù, Márta Korbonits European Journal of Endocrinology.2015; 173(4): M133. CrossRef - Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee Endocrinology and Metabolism.2015; 30(1): 47. CrossRef - Incidentally Discovered Aldosterone and Cortisol Cosecreting Adrenal Cortical Adenoma
Ji Yun Bae, Jihyun Lee, Yeji Han, Seog Ki Min, Min-Sun Cho, Yeon-Ah Sung The Ewha Medical Journal.2015; 38(3): 129. CrossRef - Subclinical Cushing's Syndrome and Metabolic Disorder
Ji Cheol Bae Endocrinology and Metabolism.2014; 29(4): 441. CrossRef
- Obesity and Metabolism
- Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes
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Chan-Hee Jung, Ae-Rin Baek, Kyu-Jin Kim, Bo-Yeon Kim, Chul-Hee Kim, Sung-Koo Kang, Ji-Oh Mok
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Endocrinol Metab. 2013;28(4):309-319. Published online December 12, 2013
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DOI: https://doi.org/10.3803/EnM.2013.28.4.309
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- Background
It is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM. MethodsA total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) ≥ or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing's protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points ≥2. Diabetic microangiopathies were assessed. ResultsPatients with CAN comprised 77% of the group with mean CIMT ≥1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT ≥1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with ≥2 carotid plaques, while they were 23% of the group with ≤1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio [OR] of 8.6 (95% confidence interval [CI], 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening. ConclusionThese results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.
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