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餐后高血糖与糖尿病的心血管并发症:最新进展

Postprandial hyperglycaemia and cardiovascular complications of diabetes: an update.

作者信息

Ceriello Antonio, Davidson Jamie, Hanefeld Markolf, Leiter Lawrence, Monnier Louis, Owens David, Tajima Naoko, Tuomilehto Jaakko

机构信息

Clinical Science Research Institute, Clinical Science Building, Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

Nutr Metab Cardiovasc Dis. 2006 Oct;16(7):453-6. doi: 10.1016/j.numecd.2006.05.006. Epub 2006 Aug 24.

Abstract

Type 2 diabetes is characterised by a gradual decline in insulin secretion in response to nutrient loads; hence, it is primarily a disorder of postprandial glucose (PPG) regulation. However, physicians continue to rely on fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) levels as indicators for disease management. There is a linear relationship between the risk of cardiovascular disease (CVD) and the two-hour oral glucose tolerance test (OGTT), while a recent study confirms postprandial hyperglycaemia as an independent risk factor for CVD in type 2 diabetes. At the same time, several intervention studies have shown that treating postprandial hyperglycaemia may reduce the incidence of new cardiovascular events. Evidence supports the hypothesis that postprandial hyperglycaemia may be linked to CVD through the generation of oxidative stress. Furthermore, clinical data suggest that postprandial hyperglycaemia is a common phenomenon, even in patients who may be considered in 'good metabolic control'. Therefore, in addition to HbA1c and FPG, physicians should consider monitoring and targeting PPG in patients with type 2 diabetes.

摘要

2型糖尿病的特征是随着营养负荷的增加胰岛素分泌逐渐减少;因此,它主要是一种餐后血糖(PPG)调节障碍。然而,医生仍然依赖空腹血糖(FPG)和糖化血红蛋白(HbA1c)水平作为疾病管理的指标。心血管疾病(CVD)风险与两小时口服葡萄糖耐量试验(OGTT)之间存在线性关系,而最近的一项研究证实餐后高血糖是2型糖尿病患者发生CVD的独立危险因素。同时,多项干预研究表明,治疗餐后高血糖可能会降低新的心血管事件的发生率。有证据支持餐后高血糖可能通过氧化应激的产生与CVD相关的假说。此外临床数据表明,即使在可能被认为“代谢控制良好”的患者中,餐后高血糖也是一种常见现象。因此,除了HbA1c和FPG之外,医生还应考虑对2型糖尿病患者监测并控制PPG。

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