Cosentino Francesco, Assenza Gabriele Egidy
Cardiology and Cardiovascular Research, University Hospital, Zurich, Switzerland.
Herz. 2004 Dec;29(8):749-59. doi: 10.1007/s00059-004-2635-8.
In the last 50 years health care systems throughout the world have faced a new epidemic dual disease: cardiovascular disease (CVD)-diabetes mellitus. Nowadays, CVD is the leading cause of death in all western countries, and 60% of deaths for ischemic heart disease and stroke occur in developing countries with fixing resources. The striking association between CAD, stroke, peripheral artery disease and diabetes, since the publication of the first large-scale epidemiologic investigation in the 1970s, has forced physicians to investigate the possible pathophysiological connection among these diverse clinical conditions. Recent and compelling evidence has shown the significant and independent role of inflammation, insulin resistance and subsequent endothelial dysfunction in the initiation and progression of atherothrombosis, superimposed on traditional risk factors. Given the up-to-date molecular data linking diabetes, endothelial dysfunction, inflammation, and atherosclerosis, this review will focus on the common mechanisms underlying these conditions and on new promising therapeutic strategies.
在过去50年里，世界各地的医疗保健系统都面临着一种新的流行性双重疾病：心血管疾病（CVD）-糖尿病。如今，心血管疾病是所有西方国家的主要死因，在资源有限的发展中国家，60%的缺血性心脏病和中风死亡病例发生。自20世纪70年代首次大规模流行病学调查发表以来，冠心病、中风、外周动脉疾病与糖尿病之间的显著关联，迫使医生去研究这些不同临床病症之间可能的病理生理联系。最近的确凿证据表明，炎症、胰岛素抵抗以及随后的内皮功能障碍在动脉粥样硬化血栓形成的起始和进展中起着重要且独立的作用，这叠加在传统风险因素之上。鉴于将糖尿病、内皮功能障碍、炎症和动脉粥样硬化联系起来的最新分子数据，本综述将聚焦于这些病症背后的共同机制以及新的有前景的治疗策略。
