Department of Pediatrics, University of Chieti, Chieti, Italy.
Diabetes Metab Res Rev. 2011 Jul;27(5):436-60. doi: 10.1002/dmrr.1195.
Diabetes represents one of the most common diseases globally. Worryingly, the worldwide incidence of type 1 diabetes (T1D) is rising by 3% per year. Despite the rapid increase in diabetes incidence, recent advances in diabetes treatment have been successful in decreasing morbidity and mortality from diabetes-related retinopathy, nephropathy, and neuropathy. In contrast, there is clear evidence for the lack of improvement in mortality for cardiovascular diseases (CVDs). This emphasizes the importance of focusing childhood diabetes care strategies for the prevention of CVD in adulthood. Furthermore, although most work on diabetes and macrovascular disease relates to type 2 diabetes, it has been shown that the age-adjusted relative risk of CVD in T1D far exceeds that in type 2 diabetes. As T1D appears predominantly during childhood, those with T1D are at greater risk for coronary events early in life and require lifelong medical attention. Because of the important health effects of CVDs in children and adolescents with T1D, patients, family members, and care providers should understand the interaction of T1D and cardiovascular risk. In addition, optimal cardiac care for the patient with diabetes should focus on aggressive management of traditional cardiovascular risk factors to optimize those well-recognized as well as new specific risk factors which are becoming available. Therefore, a complete characterization of the molecular mechanisms involved in the development and progression of macrovascular angiopathy is needed. Furthermore, as vascular abnormalities begin as early as in childhood, potentially modifiable risk factors should be identified at an early stage of vascular disease development.
糖尿病是全球最常见的疾病之一。令人担忧的是，1 型糖尿病（T1D）的全球发病率正以每年 3%的速度上升。尽管糖尿病发病率迅速上升，但最近在糖尿病治疗方面的进展成功降低了糖尿病相关视网膜病变、肾病和神经病变的发病率和死亡率。相比之下，心血管疾病（CVD）的死亡率显然没有改善的迹象。这强调了关注儿童期糖尿病护理策略以预防成年期 CVD 的重要性。此外，尽管大多数关于糖尿病和大血管疾病的研究都与 2 型糖尿病有关，但已经表明 T1D 患者 CVD 的年龄调整相对风险远远超过 2 型糖尿病。由于 T1D 主要出现在儿童期，T1D 患者在生命早期发生冠心病事件的风险更高，需要终身医疗关注。由于 CVD 在 T1D 儿童和青少年中的重要健康影响，患者、家庭成员和护理提供者应了解 T1D 和心血管风险之间的相互作用。此外，糖尿病患者的心脏最佳护理应侧重于积极管理传统心血管危险因素，以优化那些公认的和新出现的特定危险因素。因此，需要对大血管血管病变发生和进展中涉及的分子机制进行全面描述。此外，由于血管异常早在儿童期就已经开始，因此应在血管疾病发展的早期阶段确定潜在可改变的危险因素。
