Kareus Therapeutics SA, La Chaux-de-Fonds, Switzerland; NeuroPn Therapeutics, GA, Alpharetta, USA.
Trends Pharmacol Sci. 2016 Mar;37(3):207-219. doi: 10.1016/j.tips.2015.11.009. Epub 2015 Dec 21.
The major cause of death and complications in patients with type 2 diabetes (T2DM) is cardiovascular disease (CVD). More than 60% of all patients with T2DM die of CVD, and an even greater percentage have serious complications. The impact of glucose lowering on cardiovascular complications is a hotly debated issue and recent large clinical trials reported no significant decrease in cardiovascular events with intensive glucose control. Risk remains high even after correcting diabetes-associated dyslipidemia with drugs such as fibrates and niacin. Data from several clinical studies show that postprandial glucose and lipids have a strong predictive value on myocardial infarction (MI) and mortality. However, strategies to reduce postprandial hyperglycemia and/or lipemia through increased utilization of glucose and/or triglycerides (TG) have been shown to not be effective in reducing the CVD burden. In this review, I discus the preferred ways to reduce postprandial glucose and TG with combinations of currently marketed drugs with potential benefit in CVD.
2 型糖尿病（T2DM）患者死亡和并发症的主要原因是心血管疾病（CVD）。超过 60%的 T2DM 患者死于 CVD，甚至有更大比例的患者出现严重并发症。降低血糖对心血管并发症的影响是一个备受争议的问题，最近的大型临床试验报告称，强化血糖控制并未显著降低心血管事件的发生。即使使用贝特类和烟酸等药物纠正与糖尿病相关的血脂异常，风险仍然很高。来自几项临床研究的数据表明，餐后血糖和血脂对心肌梗死（MI）和死亡率具有很强的预测价值。然而，通过增加葡萄糖和/或三酰甘油（TG）的利用来降低餐后高血糖和/或高脂血症的策略已被证明不能有效降低 CVD 负担。在这篇综述中，我讨论了用目前市场上的药物联合治疗来降低餐后血糖和 TG 的首选方法，这些方法可能对 CVD 有益。
