Lastra-Gonzalez Guido, Manrique Camila Margarita, Govindarajan Gurushankar, Whaley-Connell Adam, Sowers James R
Division of Endocrinology, Harry S Truman VA Medical Center, University of Missouri-Columbia, School of Medicine, MO, USA.
Expert Opin Pharmacother. 2005 Oct;6(13):2209-21. doi: 10.1517/14656566.6.13.2209.
Cardiovascular disease (CVD) and Type 2 diabetes mellitus (DM2), once conceived as different entities, share common origins and pathways. Increased activity of the renin-angiotensin-aldosterone-system, insulin resistance, chronic low-grade inflammation and oxidative stress collectively contribute to endothelial dysfunction and atherosclerosis, which manifest clinically as CVD. Nowadays, it is possible to identify and intervene in high-risk populations even before the clinical diagnosis of DM2. The control of dietary patterns and increased physical activity is completely feasible, as well as the management of hypertension and dyslipidaemia. Pharmacological interventions targeted at blocking renin-angiotensin-aldosterone-system and sensitising to insulin have a role in the prevention of DM2 and CVD, and are avidly explored worldwide. In the near future, ongoing trials should provide data that will allow us to better treat patients with the cardiometabolic syndrome and diabetes in order to reduce CVD morbidity and mortality.
心血管疾病（CVD）和2型糖尿病（DM2），曾经被认为是不同的疾病实体，如今却有着共同的起源和发病机制。肾素-血管紧张素-醛固酮系统活性增加、胰岛素抵抗、慢性低度炎症和氧化应激共同导致内皮功能障碍和动脉粥样硬化，临床上表现为心血管疾病。如今，甚至在2型糖尿病临床诊断之前，就有可能识别并干预高危人群。控制饮食模式和增加体育活动是完全可行的，控制高血压和血脂异常也是可行的。针对阻断肾素-血管紧张素-醛固酮系统和提高胰岛素敏感性的药物干预在预防2型糖尿病和心血管疾病方面发挥着作用，并且正在全球范围内积极探索。在不久的将来，正在进行的试验应该会提供数据，使我们能够更好地治疗患有心脏代谢综合征和糖尿病的患者，以降低心血管疾病的发病率和死亡率。
