SUMMARY OBJECTIVE: This study aimed to analyze the kidneys among the subjects with early stages of type 2 diabetic kidney disease by shear wave elastography quantitatively. METHODS: A total of 108 patients with type 2 diabetic kidney disease and 17 control subjects were enrolled. According to the estimated glomerular filtration rate and urinary albumin-to-urinary creatinine ratio, patients were classified into stages 1 to 3 diabetic kidney disease. Grayscale ultrasound andshear wave elastography were performed. The sizes, depths, and shear wave elastography values were recorded. These parameters were compared between the diabetic kidney disease and the control subjects. RESULTS: The mean shear wave elastography values were significantly higher in the diabetic kidney disease group (10.156±1.75 kPa vs. 8.241±1.4 kPa; p<0.001). We obtained statistically significantly higher shear wave elastography values in stages 2 and 3 diabetic kidney disease subjects than control subjects and in patients with stage 3 diabetic kidney disease compared to those with stage 1 diabetic kidney disease (p<0.05 for all). We obtained a cutoff value of 9.23 kPa for predicting diabetic kidney disease in early stages, with a sensitivity of 67% and a specificity of 82%. CONCLUSION: Shear wave elastography may be used as a noninvasive, simple, and quantitative method to provide diagnostic information as a part of routine management of patients with type 2 diabetes mellitus, especially in the early stages of diabetic kidney disease.

BACKGROUND: Atherosclerosis that starts in childhood invariably advances during adulthood. AIM: We aimed to study the effect of obesity on main carotid artery intima-media thickness (CIMT) and arterial stiffness. MATERIAL AND METHODS: A total of 78 children were studied from October 2010 to February 2011. They were divided into obese (n=42, group 1) and normal (n=36, group 2). All children were subjected to physical examination, routine biochemical and haematological analysis, carotid ultrasonography and echocardiographic measurements. A detailed medical history was obtained. Body mass index (BMI) was calculated by dividing participants' weight in kilograms by the square of their height in metres. Stiffness index β was calculated using blood pressure and diameter of the systolic and diastolic artery. Intima-media thickness was also measured. RESULTS: The mean age of the obese and normal (control) groups was 10.12±2.12 years and 9.78±1.78 years, respectively. Weight, BMI, and systolic and diastolic blood pressure values were significantly higher in the obese group (all p<0.001). In terms of arterial stiffness and CIMT measurements, all parameters were higher in the obese group than the control (p<0.001). There was a relationship between the degree of obesity and CIMT or stiffness index p. In addition, dilatation and hypertrophy levels in the left ventricle were higher in obese children. CONCLUSIONS: Obese children with risk factors for multiple atherosclerosis could have increased CIMT dimensions and, consequently, should be screened for these risks. Ultrasonographic CIMT and arterial stiffness measurements can detect vascular damage at an early stage of development in children with cardiovascular risk factors.