Department of Cardiology, Leiden University Medical Center, The Netherlands.
Biomark Med. 2012 Feb;6(1):35-52. doi: 10.2217/bmm.11.105.
Patients with obesity and diabetes mellitus are at increased risk for cardiovascular events and have a higher cardiovascular morbidity and mortality. This worse prognosis is partly explained by the late recognition of coronary heart disease in these patients, due to the absence of symptoms. Early identification of coronary heart disease is vital, to initiate preventive medical therapy and improve prognosis. At present, with the use of cardiovascular risk models, the identification of coronary heart disease in these patients remains inadequate. To this end, biomarkers should improve the early identification of patients at increased cardiovascular risk. The first part of this review describes the pathophysiologic pathway from obesity to coronary heart disease. The second part evaluates several mediators from this pathophysiologic pathway for their applicability as biomarkers for the identification of coronary heart disease.
肥胖和糖尿病患者发生心血管事件的风险增加，心血管发病率和死亡率更高。由于这些患者无症状，导致冠心病的发现较晚，这在一定程度上解释了这种较差的预后。早期识别冠心病至关重要，可以启动预防性药物治疗并改善预后。目前，由于使用了心血管风险模型，这些患者的冠心病识别仍然不足。为此，生物标志物应该改善对心血管风险增加患者的早期识别。本综述的第一部分描述了从肥胖到冠心病的病理生理途径。第二部分评估了该病理生理途径的几种介质，以评估它们作为冠心病识别的生物标志物的适用性。
