Sarafidis Pantelis A, McFarlane Samy I, Bakris George L
1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 546 36 Thessaloniki, Greece.
Curr Diab Rep. 2007 Jun;7(3):191-9. doi: 10.1007/s11892-007-0031-5.
The effects of the antihypertensive drugs on carbohydrate metabolism and the development of diabetes have been a major research field for more than two decades. Many clinical studies have investigated the effects of the antihypertensive classes on insulin sensitivity and glycemic control, whereas several observational studies and large outcome trials have examined associations of antihypertensive agents with diabetes incidence. In general, thiazide diuretics and conventional beta blockers decrease insulin sensitivity and increase new-onset diabetes, whereas angiotensin-converting enzyme inhibitors, calcium channel blockers, and angiotensin II receptor blockers have neutral or beneficial effects on these parameters. However, several issues in this field, such as the specific properties of newer agents and the relationship of adverse metabolic outcomes and cardiovascular risk, remain to be fully elucidated. This article presents and evaluates the current knowledge in this important area.
二十多年来，抗高血压药物对碳水化合物代谢及糖尿病发展的影响一直是一个主要的研究领域。许多临床研究调查了各类抗高血压药物对胰岛素敏感性和血糖控制的影响，而一些观察性研究和大型结局试验则探讨了抗高血压药物与糖尿病发病率之间的关联。一般来说，噻嗪类利尿剂和传统β受体阻滞剂会降低胰岛素敏感性并增加新发糖尿病的发生，而血管紧张素转换酶抑制剂、钙通道阻滞剂和血管紧张素II受体阻滞剂对这些参数具有中性或有益影响。然而，该领域的几个问题，如新药物的具体特性以及不良代谢结局与心血管风险的关系，仍有待充分阐明。本文介绍并评估了这一重要领域的现有知识。
