Vesa Cosmin Mihai, Popa Loredana, Popa Amorin Remus, Rus Marius, Zaha Andreea Atena, Bungau Simona, Tit Delia Mirela, Corb Aron Raluca Anca, Zaha Dana Carmen
Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
Department II of Internal Medicine, Clinical County Emergency Hospital of Oradea, 410169 Oradea; Romania.
Diagnostics (Basel). 2020 May 16;10(5):314. doi: 10.3390/diagnostics10050314.
Reducing cardiovascular risk (CVR) is the main focus of diabetes mellitus (DM) management nowadays. Complex pathogenic mechanisms that are the subject of this review lead to early and severe atherosclerosis in DM patients. Although it is not a cardiovascular disease equivalent at the moment of diagnosis, DM subjects are affected by numerous cardiovascular complications, such as acute coronary syndrome, stroke, or peripheral artery disease, as the disease duration increases. Therefore, early therapeutic intervention is mandatory and recent guidelines focus on intensive CVR factor management: hyperglycaemia, hypertension, and dyslipidaemia. Most important, the appearance of oral or injectable antidiabetic medication such as SGLT-2 inhibitors or GLP-1 agonists has proven that an antidiabetic drug not only reduces glycaemia, but also reduces CVR by complex mechanisms. A profound understanding of intimate mechanisms that generate atherosclerosis in DM and ways to inhibit or delay them are of the utmost importance in a society where cardiovascular morbidity and mortality are predominant.
降低心血管风险(CVR)是当今糖尿病(DM)管理的主要重点。本综述所讨论的复杂致病机制会导致糖尿病患者早期出现严重动脉粥样硬化。虽然糖尿病在诊断时并非等同于心血管疾病,但随着病程延长,糖尿病患者会受到多种心血管并发症的影响,如急性冠状动脉综合征、中风或外周动脉疾病。因此,早期治疗干预必不可少,近期的指南聚焦于强化心血管风险因素管理:高血糖、高血压和血脂异常。最重要的是,口服或注射用抗糖尿病药物(如钠-葡萄糖协同转运蛋白2抑制剂或胰高血糖素样肽-1激动剂)的出现已证明,一种抗糖尿病药物不仅能降低血糖,还能通过复杂机制降低心血管风险。在心血管发病率和死亡率居高不下的社会中,深入了解糖尿病中引发动脉粥样硬化的内在机制以及抑制或延缓这些机制的方法至关重要。