胰岛素增敏剂对心血管系统的潜在益处。

Potential cardiovascular benefits of insulin sensitizers.

作者信息

Kunhiraman Biju P, Jawa Ali, Fonseca Vivian A

机构信息

Section of Endocrinology, Diabetes, and Metabolism, Tulane University and Hospital, 1430 Tulane Avenue, New Orleans, LA 70112, USA.

出版信息

Endocrinol Metab Clin North Am. 2005 Mar;34(1):117-35. doi: 10.1016/j.ecl.2004.11.005.

DOI:10.1016/j.ecl.2004.11.005

PMID:15752925

Abstract

A multiple risk factor approach is needed in patients who have type 2 diabetes. Because many risk factors are linked with IR, treatment with insulin sensitizers has the potential to modulate these risk factors favorably. TZDs 'have many important effects beyond lowering blood glucose. By targeting IR, they improve many cardiovascular risk factors that are associated with the IR syndrome. In particular, they increase HDL-C, have anti-inflammatory effects, improve endothelial function and fibrinolysis, and decrease carotid intimal thickness; however, no evidence-based studies on cardiovascular outcomes are available to substantiate the potential cardioprotective effects of TZDs. Several clinical trials that were designed to investigate the effect that these agents have on reducing cardiovascular events are well under way.

摘要

对于2型糖尿病患者，需要采取多危险因素干预方法。由于许多危险因素与胰岛素抵抗（IR）相关，使用胰岛素增敏剂进行治疗有可能对这些危险因素产生有益的调节作用。噻唑烷二酮类药物（TZDs）除了降低血糖外还有许多重要作用。通过针对IR，它们改善了许多与IR综合征相关的心血管危险因素。特别是，它们可提高高密度脂蛋白胆固醇（HDL-C）水平，具有抗炎作用，改善内皮功能和纤维蛋白溶解，并减少颈动脉内膜厚度；然而，尚无基于证据的研究来证实TZDs潜在的心脏保护作用。旨在研究这些药物对减少心血管事件影响的几项临床试验正在顺利进行。