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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제58권 제1호
발행연도
2017.1
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75 - 81 (7page)

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Purpose: Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor forcardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocolin ESRD patients. Materials and Methods: Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring,and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascularand Metabolic disease Etiology Research Center-HIgh risk cohort. Results: The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV riskfactors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014),PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DMand the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regressionanalysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence ofCAD (p=0.046). Conclusion: Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DMcontrol group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.

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