Singaram Vanitha, Pratley Richard
Diabetes and Metabolism Translational Medicine Unit, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Vermont College of Medicine, Burlington, VT 05405, USA.
Diab Vasc Dis Res. 2007 Sep;4(3):237-40. doi: 10.3132/dvdr.2007.047.
Patients with type 2 diabetes mellitus (T2DM) are at high risk for cardiovascular disease (CVD). This complication accounts for much of the increased morbidity, mortality and costs of care associated with diabetes. Hypertension, dyslipidaemia, a pro-inflammatory phenotype, abnormal fibrinolysis and platelet activation, insulin resistance and high blood glucose concentrations all contribute to the increased risk of macrovascular disease in diabetes. Although reducing low-density lipoprotein (LDL)-cholesterol, controlling blood pressure, angiotensin-converting enzyme (ACE) inhibitors and aspirin have been shown to decrease CVD in diabetes, it is less clear that lowering glucose levels decreases risk. The PROactive trial was undertaken to test whether treatment with the thiazolidinedione pioglitazone could decrease the number of CVD events in high-risk patients with T2DM.
2型糖尿病（T2DM）患者患心血管疾病（CVD）的风险很高。这种并发症是糖尿病相关发病率、死亡率和护理成本增加的主要原因。高血压、血脂异常、促炎表型、异常纤维蛋白溶解和血小板活化、胰岛素抵抗以及高血糖浓度均导致糖尿病患者发生大血管疾病的风险增加。尽管降低低密度脂蛋白（LDL）胆固醇、控制血压、使用血管紧张素转换酶（ACE）抑制剂和阿司匹林已被证明可降低糖尿病患者的CVD风险，但降低血糖水平是否能降低风险尚不清楚。开展了PROactive试验，以测试噻唑烷二酮类药物吡格列酮治疗能否减少高危T2DM患者的CVD事件数量。
