PMID- 27861342
OWN - NLM
STAT- MEDLINE
DCOM- 20170224
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 46
DP  - 2016 Nov
TI  - Long-term effects intensive medical therapy on the development and progression of 
      subclinical atherosclerosis and the metabolic syndrome in Chinese patients with 
      type 2 diabetes mellitus.
PG  - e5201
LID - 10.1097/MD.0000000000005201 [doi]
LID - e5201
AB  - BACKGROUND: Few studies have investigated the progression of subclinical 
      atherosclerosis and metabolic syndrome (MetS) in Chinese patients with type 2 
      diabetes mellitus (T2DM). This study was to compare the long-term effects of 
      intensive medical therapy on the development and progression of subclinical 
      atherosclerosis and MetS in Chinese T2DM patients with that of a conventional 
      treatment regimen. METHODS: A total of 316 T2DM patients were randomized to 
      receive conventional pharmacological treatment or intensive medical therapy, 
      consisting of diet and exercise counseling, from 2002 to 2014 at our hospital in 
      Changsha, China. Clinical indicators of subclinical atherosclerosis and MetS were 
      evaluated over the 12-year follow-up period. A chi analysis or t tests was used to 
      compare the data between the 2 groups. Risk factors for subclinical 
      atherosclerosis were identified using Cox proportional hazard models. RESULTS: 
      The incidence of subclinical atherosclerosis increased in both groups over time, 
      and did not differ significantly between the 2 groups at the end of the study. 
      However, after 6 years of treatment, the risk of subclinical atherosclerosis was 
      significantly lower in the intensive medical therapy group, based on intima-media 
      thickness (IMT) measurements, compared with that in the conventional treatment 
      (44.2% vs. 69.7%; P < 0.01). Age, creatinine, and IMT of the common iliac artery 
      were significantly associated with subclinical atherosclerosis. Although the 
      indicators of MetS did not differ significantly at the end of study, the success 
      rate for the management of MetS in the intensive medical therapy group was 
      significantly higher than that in the conventional treatment group in 2006, 2008, 
      2010, and 2012. CONCLUSIONS: The incidence of atherosclerosis in the intensive 
      medical therapy group was significantly lower than that in the conventional 
      treatment group from 2006 to 2010 (P < 0.05), and the incidence of MetS in the 
      intensive medical therapy group was significantly higher than that in the 
      conventional treatment group from 2006 to 2012. Kaplan-Meier estimations showed 
      that the risk of subclinical atherosclerosis in the intensive medical therapy 
      group was significantly lower than that in the conventional treatment group 
      (P < 0.001), whereas the risk of MetS was not significantly different between the 
      treatment groups (P > 0.05).
FAU - Liu, Zhiwen
AU  - Liu Z
AD  - Department of Endocrinology, Xuhui District Central Hospital, Shanghai Department 
      of Endocrinology B-Ultrasound Room, Second Xiangya Hospital of Central South 
      University, Changsha, China.
FAU - Zhou, Zhiguang
AU  - Zhou Z
FAU - Huang, Gan
AU  - Huang G
FAU - Xiao, Yang
AU  - Xiao Y
FAU - Li, Zhen
AU  - Li Z
FAU - Liu, Cong
AU  - Liu C
FAU - Na, Risu
AU  - Na R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Aged
MH  - Atherosclerosis/epidemiology/*etiology
MH  - Diabetes Mellitus, Type 2/*complications/*therapy
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Metabolic Syndrome/epidemiology/*etiology
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC5120899
COIS- The authors declare no conflict of interest with regard to the publication of 
      this research report.
EDAT- 2016/11/20 06:00
MHDA- 2017/02/25 06:00
PMCR- 2016/11/18
CRDT- 2016/11/19 06:00
PHST- 2016/11/19 06:00 [entrez]
PHST- 2016/11/20 06:00 [pubmed]
PHST- 2017/02/25 06:00 [medline]
PHST- 2016/11/18 00:00 [pmc-release]
AID - 00005792-201611150-00013 [pii]
AID - 10.1097/MD.0000000000005201 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Nov;95(46):e5201. doi: 10.1097/MD.0000000000005201.