Bartnik M, Norhammar A, Rydén L
Department of Medicine, Kärnsjukhuset, Skövde, Sweden.
J Intern Med. 2007 Aug;262(2):145-56. doi: 10.1111/j.1365-2796.2007.01831.x.
Coronary artery disease and type 2 diabetes are chronic diseases of substantial and growing prevalence. Their coincidence is common, markedly enhancing mortality and morbidity. The risk for cardiovascular disease increases along a spectrum of blood glucose concentrations already apparent at levels regarded as normal. Accordingly, strategies for the early detection of glucometabolic disturbances are needed to find ways to prevent the occurrence of cardiovascular complications or to treat them already at an early stage. More specifically, abnormal glucose tolerance is almost twice as common amongst patients with a myocardial infarction as in population-based controls and a normal glucose regulation is indeed less common than abnormal glucose metabolism also amongst patients with stable coronary artery disease. Already an abnormal glucose tolerance is a strong risk factor for future cardiovascular events after an acute myocardial infarction. An oral glucose tolerance test should, therefore, be a part of the evaluation of total risk in all patients with coronary artery disease. As glucose disturbances are common and easy to detect, they may be suitable targets for novel secondary preventive efforts.
冠状动脉疾病和2型糖尿病是患病率持续大幅上升的慢性疾病。它们常常同时出现，显著增加了死亡率和发病率。在被视为正常的血糖浓度范围内，心血管疾病风险会随着血糖水平的变化而增加。因此，需要早期检测糖代谢紊乱的策略，以找到预防心血管并发症发生或在早期阶段进行治疗的方法。具体而言，心肌梗死患者中糖耐量异常的发生率几乎是基于人群的对照组的两倍，而且在稳定型冠状动脉疾病患者中，正常糖代谢的情况确实比糖代谢异常更为少见。急性心肌梗死后，糖耐量异常本身就是未来发生心血管事件的一个强大危险因素。因此，口服葡萄糖耐量试验应成为所有冠状动脉疾病患者总体风险评估的一部分。由于糖代谢紊乱很常见且易于检测，它们可能是新型二级预防措施的合适目标。
