Pérez Antonio, González Blanco Cintia, Hernández-Presa Miguel Ángel, Chaves José
Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Endocrinol Nutr. 2011 Jun-Jul;58(6):283-90. doi: 10.1016/j.endonu.2011.03.005.
To assess the therapeutic approach and lipid goal achievement in a spanish diabetic population at high cardiovascular risk.
A multicenter, descriptive, cross-sectional study consecutively recruited the first 10 patients who attended the primary care office and had been seen in the 12 months prior to the study visit. Inclusion criteria were type 2 diabetes without cardiovascular disease, LDL cholesterol levels ≤160mg/dL, triglyceride levels ≤600mg/dL, and at least one of the following: retinopathy, albuminuria, current smoking, or hypertension.
A total of 2412 patients were evaluated (aged 61.3±8.3 years, 46.8% women, diabetes duration 8.6±7.4 years). As compared to the previous visit (8.1±5 months before), the proportion of patients who achieved LDL-C levels <100mg/dL (22.7% vs 28.6%), non-HDL-C levels <130mg/dL (27.7% vs 33.8%) and both goals (17.6% vs 22.1%) significantly increased at the time of assessment. Statins were the most widely prescribed lipid-lowering drugs (65.5%) and the lipid-lowering drug was changed from the previous visit in 38.7% of patients, drug dosage was increased in 17.3%, and another drug was added in 5%.
Use of more potent statins and higher statin doses were the most commonly used therapeutic strategies for improving control of dyslipidemia in patients with type 2 diabetes, but these changes were clearly inadequate to achieve lipid goals in most patients with type 2 diabetes.
评估西班牙心血管高危糖尿病患者的治疗方法及血脂目标达成情况。
一项多中心、描述性横断面研究，连续招募了前10名到初级保健诊所就诊且在研究访视前12个月内曾就诊的患者。纳入标准为无心血管疾病的2型糖尿病、低密度脂蛋白胆固醇水平≤160mg/dL、甘油三酯水平≤600mg/dL，以及以下至少一项：视网膜病变、蛋白尿、当前吸烟或高血压。
共评估了2412例患者（年龄61.3±8.3岁，女性占46.8%，糖尿病病程8.6±7.4年）。与上次就诊时（评估前8.1±5个月）相比，评估时低密度脂蛋白胆固醇水平<100mg/dL的患者比例（22.7%对28.6%）、非高密度脂蛋白胆固醇水平<130mg/dL的患者比例（27.7%对33.8%）以及两项血脂目标均达标的患者比例（17.6%对22.1%）均显著增加。他汀类药物是最常用的降脂药物（65.5%），38.7%的患者降脂药物与上次就诊时不同，17.3%的患者增加了药物剂量，5%的患者加用了另一种药物。
使用更强效的他汀类药物和更高剂量的他汀是改善2型糖尿病患者血脂异常控制的最常用治疗策略，但这些改变显然不足以使大多数2型糖尿病患者达到血脂目标。
