Roberto Robles Nicolás, Barroso Sergio, Marcos Gonzalo, Sánchez Muñoz-Torrero Juan Francisco
Cátedra de Riesgo Cardiovascular, Facultad de Medicina. Universidad de Salamanca, Salamanca, España.
Endocrinol Nutr. 2009 Mar;56(3):112-7. doi: 10.1016/S1575-0922(09)70840-X. Epub 2009 May 18.
Our study aimed to assess the prevalence and degree of control of dyslipemia, using the 2004 National Cholesterol Education Program criteria, as well as the use of cholesterol lowering drugs in a sample of diabetic patients followed up in primary care settings in Extremadura.
In this crosssectional, multicenter study the prevalence and control of cardiovascular risk factors was assessed in a sample of 1022 patients having at least one cardiovascular risk factors who were recruited by general practitioners. A total of 988 subjects were avalaible for statistic analysis of dyslipemia; 320 patients had diabetes mellitus (DM); 178 had at least one cardiovascular disease without diabetes and 506 patients without those diseases were used as control.
Total cholesterol and low density lipoprotein (LDL) fraction were higher in the group control. High density lipoprotein (HDL)-cholesterol was lower in the group DM as compared to control. Triglycerides were higher in group DM. Women had higher HDL-cholesterol and lower triglycerides levels than men. Only 26.6% of diabetics subjetcs and 28.9% of group ECV were well controlled; 42.5% of the control group had LDL cholesterol < 130 mg/dl. 13.3% of diabetics patients suffering from coronary artery disease had LDL-cholesterol < 70 mg/dl. They were taking statins: DM, 56.6); ECV 61.6%; and control, 39.4%. From patients who did not take cholesterol lowering drugs 51.6% in group DM and 33.8% in group ECV would need to take them.
The study shows a poor control of dyslipemia in diabetics subjects and high risk patients in spite of lower lipid levels when compared to lower risk population and a more frequent use of cholesterol lowering drugs. Nevertheless, statin use is still lower than currently recommended.
我们的研究旨在采用2004年国家胆固醇教育计划标准,评估埃斯特雷马杜拉初级保健机构中随访的糖尿病患者样本中的血脂异常患病率和控制程度,以及降胆固醇药物的使用情况。
在这项横断面多中心研究中,对1022名至少有一项心血管危险因素的患者样本进行了心血管危险因素患病率和控制情况评估,这些患者由全科医生招募。共有988名受试者可用于血脂异常的统计分析;320例患者患有糖尿病(DM);178例患有至少一种无糖尿病的心血管疾病,506例无这些疾病的患者作为对照。
对照组的总胆固醇和低密度脂蛋白(LDL)分数较高。与对照组相比,DM组的高密度脂蛋白(HDL)胆固醇较低。DM组的甘油三酯较高。女性的HDL胆固醇水平高于男性,甘油三酯水平低于男性。只有26.6%的糖尿病患者和28.9%的心血管疾病组得到良好控制;42.5%的对照组低密度脂蛋白胆固醇<130mg/dl。13.3%患有冠状动脉疾病的糖尿病患者低密度脂蛋白胆固醇<70mg/dl。他们正在服用他汀类药物:DM组为56.6%;心血管疾病组为61.6%;对照组为39.4%。在未服用降胆固醇药物的患者中,DM组有51.6%、心血管疾病组有33.8%需要服用此类药物。
该研究表明,尽管与低风险人群相比糖尿病患者和高风险患者的血脂水平较低,但血脂异常的控制情况较差,且降胆固醇药物的使用更为频繁。然而,他汀类药物的使用仍低于目前的推荐水平。