Ceriello Antonio
Warwick Medical School, Clinical Sciences Research Institute, University Hospital, Coventry, Warwickshire, UK.
Diabetes Metab Res Rev. 2008 Jan-Feb;24(1):14-26. doi: 10.1002/dmrr.790.
In the last few years, there has been increasing focus on the impact of interventions on cardiovascular outcomes in patients with type 2 diabetes. Insulin resistance and hyperglycaemia often co-exist with a cluster of risk factors for coronary artery disease, but the underlying mechanisms leading to the development of such vascular complications are complex. The over-production of free radicals in patients suffering from diabetes results in a state of oxidative stress, which leads to endothelial dysfunction and a greater risk of atherosclerosis. Moreover, inflammatory factors which play a critical role in atherothrombosis and plaque rupture are often found to be at elevated levels in this patient population. Thiazolidinediones (TZDs) are now routinely used to manage glucose levels, and have been suggested to influence other cardiovascular risk factors and therefore the pathways leading to macrovascular events. Consequently, recent studies have investigated the anti-inflammatory and anti-atherogenic properties of TZDs. The data available up to the present time, in the context of the emerging cardiovascular outcome profiles of rosiglitazone and pioglitazone, will be discussed here.
在过去几年中，人们越来越关注干预措施对2型糖尿病患者心血管结局的影响。胰岛素抵抗和高血糖常常与一系列冠状动脉疾病风险因素并存，但导致此类血管并发症发生的潜在机制很复杂。糖尿病患者体内自由基的过度产生会导致氧化应激状态，进而导致内皮功能障碍和动脉粥样硬化风险增加。此外，在动脉粥样硬化血栓形成和斑块破裂中起关键作用的炎症因子，在这类患者群体中往往处于较高水平。噻唑烷二酮类药物（TZDs）目前常用于控制血糖水平，并被认为会影响其他心血管风险因素，从而影响导致大血管事件的途径。因此，近期的研究对TZDs的抗炎和抗动脉粥样硬化特性进行了调查。本文将讨论在罗格列酮和吡格列酮新出现的心血管结局情况背景下，截至目前可得的数据。
