2型糖尿病患者的心血管危险因素。我们遵循指南了吗？

Cardiovascular risk factors in patients with type 2 diabetes. Do we follow the guidelines?

作者信息

del Cañizo-Gómez Francisco Javier, Moreira-Andrés María Natividad

机构信息

Endocrinology Unit, Hospital Virgen de la Torre, Puerto Lumbreras 5, 28031 Madrid, Spain.

出版信息

Diabetes Res Clin Pract. 2004 Aug;65(2):125-33. doi: 10.1016/j.diabres.2003.12.002.

DOI:10.1016/j.diabres.2003.12.002

PMID:15223224

Abstract

OBJECTIVE

To assess the degree of control of modifiable cardiovascular risk factors (CRFs) in type 2 diabetic patients.

STUDY DESIGN AND METHODS

Cross-sectional study in 501 patients with type 2 diabetes mellitus. The following parameters were used to define optimal control: glycated haemoglobin (HbA(1C)) <7.0%, fasting plasma glucose (FPG) <7.2 mmol/l, postprandial capillary glucose (PCG) <10.0 mmol/l, high-density lipoprotein cholesterol (HDL-C) >1.1 mmol/l, low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/l, triglyceride levels (TG) <1.7 mmol/l, systolic blood pressure (SBP) <130 mmHg, diastolic blood pressure (DBP) <80 mmHg, body mass index (BMI) <25 kg/m2, waist circumference (WC) <88 cm in women and <102 cm in men, and current non-smoking status. The use of various cardioprotective medications was also evaluated.

RESULTS

Mean (+/-S.D.) age was 65.4 +/- 11.9 years, 218 (44%) were male. Ninety-six (19%) met coronary artery disease (CAD). Two hundred seven patients (41%) had an HbA(1C) <7.0%, 134 (27%) a FPG <7.2 mmol/l and 231 of 353 (65%) a PCG <10.0 mmol/l. Only 206 (41%) achieved an LDL-C <2.6 mmol/l, but 370 (74%) and 308 (62%) reached an HDL-C >1.1 mmol/l and a TG levels <1.7 mmol/l, respectively. In 359 (72%) patients DBP was <80 mmHg, but in only 136 (27%) was SBP <130 mmHg. Sixty four (13%) achieved a BMI <25 kg/m2, and 420 (84%) were non-smokers. Forty three (15%) women and 104 (48%) men had a WC <88 or <102 cm, respectively. None of the patients had optimal control of all CRFs.

CONCLUSIONS

These data demonstrate poor control of modifiable CRFs in the population studied, and support the need for great effort to achieve the recommended goals.

摘要

目的

评估2型糖尿病患者中可改变的心血管危险因素（CRFs）的控制程度。

研究设计与方法

对501例2型糖尿病患者进行横断面研究。采用以下参数定义最佳控制：糖化血红蛋白（HbA1C）<7.0%，空腹血糖（FPG）<7.2 mmol/L，餐后毛细血管血糖（PCG）<10.0 mmol/L，高密度脂蛋白胆固醇（HDL-C）>1.1 mmol/L，低密度脂蛋白胆固醇（LDL-C）<2.6 mmol/L，甘油三酯水平（TG）<1.7 mmol/L，收缩压（SBP）<130 mmHg，舒张压（DBP）<80 mmHg，体重指数（BMI）<25 kg/m²，女性腰围（WC）<88 cm，男性<102 cm，以及当前不吸烟状态。还评估了各种心脏保护药物的使用情况。

结果

平均（±标准差）年龄为65.4±11.9岁，218例（44%）为男性。96例（19%）患有冠状动脉疾病（CAD）。207例患者（41%）的HbA1C<7.0%，134例（27%）的FPG<7.2 mmol/L，353例中的231例（65%）的PCG<10.0 mmol/L。只有206例（41%）的LDL-C<2.6 mmol/L，但分别有370例（74%）和308例（62%）的HDL-C>1.1 mmol/L和TG水平<1.7 mmol/L。359例（72%）患者的DBP<80 mmHg，但只有136例（27%）的SBP<130 mmHg。64例（13%）的BMI<25 kg/m²，420例（84%）不吸烟。分别有43例（15%）女性和104例（48%）男性的WC<88或<102 cm。没有患者对所有CRFs都实现了最佳控制。