Jadhav S, Petrie J, Ferrell W, Cobbe S, Sattar N
Department of Medical Cardiology, Glasgow Royal Infirmary, Glasgow G31 2ER, UK.
Heart. 2004 Dec;90(12):1379-83. doi: 10.1136/hrt.2004.035170.
There is good evidence to suggest that insulin resistance and its surrogate markers are at least modest independent cardiovascular risk factors. However, as well as long term effects on atheromatous coronary disease, there is a well described correlation between markers of insulin resistance and endothelial dysfunction. In this review, the evidence for a relation between endothelial dysfunction and myocardial ischaemia is summarised. The evidence for a correlation between insulin resistance and endothelial dysfunction and the proposed cellular mechanisms are also examined. Finally, the potential role for insulin sensitising strategies is looked at and recent data examining their effects on both endothelial function and clinical symptoms is examined. In conclusion, it was found that insulin sensitising modalities have a potential role in the amelioration of angina and that randomised controlled studies are therefore warranted.
有充分证据表明胰岛素抵抗及其替代标志物至少是中度独立的心血管危险因素。然而，除了对动脉粥样硬化性冠心病的长期影响外，胰岛素抵抗标志物与内皮功能障碍之间也存在着明确的相关性。在这篇综述中，总结了内皮功能障碍与心肌缺血之间关系的证据。还研究了胰岛素抵抗与内皮功能障碍之间相关性的证据以及提出的细胞机制。最后，探讨了胰岛素增敏策略的潜在作用，并研究了近期关于其对内皮功能和临床症状影响的数据。总之，发现胰岛素增敏方式在改善心绞痛方面具有潜在作用，因此有必要进行随机对照研究。
