Cardiology Unit, Department of Medicine, Heart and Vascular Theme, Karolinska Institute, Karolinska University Hospital, 171 76, Stockholm, Sweden.
Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Stockholm, Sweden.
Cardiovasc Diabetol. 2018 Jan 24;17(1):21. doi: 10.1186/s12933-018-0665-4.
Dysglycaemia defined as type 2 diabetes (T2DM) and impaired glucose tolerance (IGT), increases the risk of cardiovascular disease (CVD). The negative impact is more apparent in the presence of hypertension and/or dyslipidaemia. Thus, it seems reasonable to screen for dysglycaemia in patients treated for hypertension and/or dyslipidaemia. A simple screening algorithm would enhance the adoption of such strategy in clinical practice.
To test the hypotheses (1) that dysglycaemia is common in patients with hypertension and/or dyslipidaemia and (2) that initial screening with the Finnish Diabetes Risk Score (FINDRISC) will decrease the need for laboratory based tests.
2395 patients (age 18-80 years) without (i) a history of CVD or TDM2, (ii) prescribed blood pressure and/or lipid lowering drugs answered the FINDRISC questionnaire and had an oral glucose tolerance test (OGTT) and HbA1c measured.
According to the OGTT 934 (39%) had previously undetected dysglycaemia (T2DM 19%, IGT 20%). Of patients, who according to FINDRISC had a low, moderate or slightly elevated risk 20, 34 and 41% and of those in the high and very high-risk category 49 and 71% had IGT or T2DM respectively. The OGTT identified 92% of patients with T2DM, FPG + HbA1c 90%, FPG 80%, 2hPG 29% and HbA1c 22%.
(1) The prevalence of dysglycaemia was high in patients treated for hypertension and/or dyslipidaemia. (2) Due to the high proportion of dysglycaemia in patients with low to moderate FINDRISC risk scores its initial use did not decrease the need for subsequent glucose tests. (3) FPG was the best test for detecting T2DM. Its isolated use is limited by the inability to disclose IGT. A pragmatic strategy, decreasing the demand for an OGTT, would be to screen all patients with FPG followed by OGTT in patients with IFG.
定义为 2 型糖尿病（T2DM）和糖耐量受损（IGT）的糖代谢异常会增加心血管疾病（CVD）的风险。在存在高血压和/或血脂异常的情况下，这种负面影响更为明显。因此，对接受高血压和/或血脂异常治疗的患者进行糖代谢异常筛查似乎是合理的。简单的筛查算法将增强这种策略在临床实践中的应用。
检验以下假设：（1）糖代谢异常在高血压和/或血脂异常患者中很常见；（2）使用芬兰糖尿病风险评分（FINDRISC）进行初步筛查将减少对实验室检查的需求。
2395 名年龄在 18-80 岁之间的患者（（i）无 CVD 或 TDM2 病史，（ii）未服用降压和/或降脂药物）回答了 FINDRISC 问卷，并进行了口服葡萄糖耐量试验（OGTT）和糖化血红蛋白（HbA1c）检测。
根据 OGTT，934 例（39%）患者有先前未被发现的糖代谢异常（T2DM 19%，IGT 20%）。根据 FINDRISC，低、中、轻度升高风险的患者分别为 20%、34%和 41%，高和极高风险的患者分别为 49%和 71%患有 IGT 或 T2DM。OGTT 检测到 92%的 T2DM 患者，FPG+HbA1c 为 90%，FPG 为 80%，2hPG 为 29%，HbA1c 为 22%。
（1）在接受高血压和/或血脂异常治疗的患者中，糖代谢异常的患病率较高。（2）由于 FINDRISC 风险评分低至中度的患者中糖代谢异常的比例较高，因此其初始使用并未减少随后进行葡萄糖检测的需求。（3）FPG 是检测 T2DM 的最佳检测方法。由于不能发现 IGT，其单独使用受到限制。一种实用的策略是筛选所有患者的 FPG，然后对 IFG 患者进行 OGTT。
Zotero 插件
