Schainberg Arnaldo, Ribeiro-Oliveira Antônio, Ribeiro José Marcio
Hospital Governador Israel Pinheiro, Instituto de Previdência dos Servidores do Estado de Minas Gerais, Departamento de Endocrinologia, Belo Horizonte, MG, Brazil.
Arq Bras Endocrinol Metabol. 2010;54(5):488-97. doi: 10.1590/s0004-27302010000500010.
It has been well documented that there is an increased prevalence of standard cardiovascular (CV) risk factors in association with diabetes and with diabetes-related abnormalities. Hyperglycemia, in particular, also plays an important role. Heart failure (HF) has become a frequent manifestation of cardiovascular disease (CVD) among individuals with diabetes mellitus. Epidemiological studies suggest that the effect of hyperglycemia on HF risk is independent of other known risk factors. Analysis of datasets from populations including individuals with dysglycemia suggests the pathogenic role of hyperglycemia on left ventricular function and on the natural history of HF. Despite substantial epidemiological evidence of the relationship between diabetes and HF, data from available interventional trials assessing the effect of a glucose-lowering strategy on CV outcomes are limited. To provide some insight into these issues, we describe in this review the recent important data to understand the natural course of CV disease in diabetic individuals and the role of hyperglycemia at different times in the progression of HF.
有充分的文献记载，与糖尿病及糖尿病相关异常情况相关的标准心血管（CV）危险因素的患病率有所增加。尤其是高血糖也起着重要作用。心力衰竭（HF）已成为糖尿病患者中心血管疾病（CVD）的常见表现。流行病学研究表明，高血糖对HF风险的影响独立于其他已知危险因素。对包括血糖异常个体在内的人群数据集的分析表明，高血糖对左心室功能和HF自然病程具有致病作用。尽管有大量关于糖尿病与HF之间关系的流行病学证据，但评估降糖策略对CV结局影响的现有干预试验数据有限。为了深入了解这些问题，我们在本综述中描述了最近的重要数据，以了解糖尿病个体中CV疾病的自然病程以及高血糖在HF进展不同阶段的作用。
