제2형 당뇨병환자에서 요 알부민 크레아티닌 비와 관상동맥 석회화와의 관련성 = Original Articles : The Association Between Urinary Albumin to Creatinine Ratio and Coronary Artery Calcification in Type 2 Diabetic Patients

국문 초록 (Abstract)

연구배경: 제2형 당뇨병환자에게 주된 사망원인인 관상동맥질환에서 죽상경화증의 진행은 칼슘 축적과 밀접하게 관련되어 있으며 이는 관상동맥 전산화 단층촬영술을 통해 정량화할 수 있다. 또한 미세알부민뇨는 심혈관질환의 독립적인 위험인자로 알려져 있다. 이에 제2형 당뇨병환자를 대상으로 미세알부민뇨와 관상동맥 석회화 정도의 연관성에 대해 알아보고자 하였다. 방법: 다중박편 나선형 전산화 단층촬영술을 시행한 제2형 당뇨병환자 155명을 대상으로 요 알부민 크레아티닌 비에 따른 환자들의 임상적 특징 및 관상동맥 석회화 점수를 조사하였다. 결과: 요 알부민 크레아티닌 비가 증가함에 따라서 관상동맥 석회화 점수는 유의하게 증가하였다. 이외에 나이, 당뇨병 유병기간, Apo A1, Log hs-CRP가 관상동맥 석회화 점수와 유의한 관계를 보였으며 다중회귀분석으로 연령을 보정한 뒤에도 요 알부민 크레아티닌 비는 관상동맥 석회화 점수와 유의한 관련성을 보여주었다. 결론: 요 알부민 크레아티닌 비는 제2형 당뇨병환자에서 관상동맥 석회화를 예측할 수 있으며 이는 심혈관질환의 고위험군 환자관리에 도움을 줄 수 있을 것이다. 더 많은 환자를 대상으로 한 혈중 석회화 관련 수치의 발굴 및 혈관합병증의 공통된 기전에 대한 추가적인 연구를 필요로 한다.

다국어 초록 (Multilingual Abstract)

Background: Atherosclerosis, the most common cause of death in type 2 diabetic patients, is closely associated with coronary artery calcium deposition. The coronary calcifications can be easily measured using coronary calcium scoring computed tomography (CT). And microalbuminuria is known as an independent risk factor of cardiovascular disease. So, we examined the association of urinary albumin to creatinine ratio (UACR) and coronary calcification score (CCS) in type 2 diabetic patients. Methods: Among type 2 diabetic patients who underwent the multidetector CT scanning for the evaluation of CCS at Kyungpook National University Hospital between December 2007 and May 2008, 155 subjects were included. CCS, demographic and laboratory data were assessed. Results: Coronary artery calcifications were identified in 90 patients (51%) and mean, median CCS was 205.8±476.9, 8.74 (0, 132.0). 60 subjects revealed UACR greater than 30 ug/mg. With the UACR increment, CCS revealed a significant increase (P<0.001). Age, duration of diabetes, serum Apo A1 level, serum high sensitivity C-reactive protein (hs-CRP) level were also associated with CCS. However, after adjusting for age, UACR and CCS exhibited a significant positive relationship (P=0.002). Conclusion: Increased UACR is associated with coronary artery calcification in type 2 diabetic patients and these results will be useful in early evaluating the presence of macrovascular complications in these patients. (Korean Diabetes J 33:289-298, 2009)

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