Gagliardino Juan J, Salazar Martin R, Espeche Walter G, Tolosa Chapasian Paula E, Gomez Garizoain Daniela, Olano Ricardo D, Stavile Rodolfo N, Balbín Eduardo, Martinez Camilo, Leiva Sisnieguez Betty C, Leiva Sisnieguez Carlos E, Carbajal Horacio A
CENEXA, Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET-CEAS CICPBA), Facultad de Ciencias Médicas UNLP, La Plata 1900, Buenos Aires, Argentina.
Unidad de Enfermedades Cardiometabólicas, Hospital General San Martín, La Plata 1900, Buenos Aires, Argentina.
J Clin Med. 2021 Jul 23;10(15):3251. doi: 10.3390/jcm10153251.
To evaluate arterial stiffness indicators in people with prediabetes (PreD) and its possible pathogenesis.
Pulse wave velocity (PWV) was measured in 208 people with FINDRISC ≥ 13 (57 ± 8 years old, 68.7% women) and thereafter divided into those having either normal glucose tolerance (NGT) or PreD. In each subgroup we also identified those with/out insulin resistance (IR) measured by the triglyceride/HDL-c ratio (normal cut off values previously established in our population). Clinical and metabolic data were collected for all participants. PWV was compared between subgroups using independent t test.
Women and men had comparable clinical and metabolic characteristics with obesity (BMI ≥ 30) and antihypertensive-statin treatment, almost half with either NGT or PreD. Whereas 48% of NGT people presented IR (abnormally high TG/HDL-c ratio), 52% had PreD. PWV was significantly higher only in those with a complete picture of metabolic syndrome (MS).
Since PWV was significantly impaired in people with a complete picture of MS, clinicians must carefully search for early diagnosis of this condition and prescribe a healthy life-style to prevent development/progression of CVD. This proactive attitude would provide a cost-effective preventive strategy to avoid CVD's negative impact on patients' quality of life and on health systems due to their higher care costs.
评估糖尿病前期（PreD）患者的动脉僵硬度指标及其可能的发病机制。
对208名芬兰糖尿病风险评分（FINDRISC）≥13的患者（年龄57±8岁，女性占68.7%）进行脉搏波速度（PWV）测量，然后将其分为糖耐量正常（NGT）组和糖尿病前期组。在每个亚组中，我们还通过甘油三酯/高密度脂蛋白胆固醇比值（此前在我们的人群中确定的正常临界值）确定有无胰岛素抵抗（IR）的患者。收集所有参与者的临床和代谢数据。使用独立t检验比较亚组之间的PWV。
男性和女性在肥胖（BMI≥30）和接受抗高血压他汀类药物治疗方面具有可比的临床和代谢特征，几乎一半患者为NGT或PreD。NGT组中48%存在IR（甘油三酯/高密度脂蛋白胆固醇比值异常高），52%患有PreD。仅在具有完整代谢综合征（MS）表现的患者中PWV显著更高。
由于具有完整MS表现的患者PWV显著受损，临床医生必须仔细筛查该疾病的早期诊断，并开出健康的生活方式处方以预防心血管疾病（CVD）的发生/进展。这种积极主动的态度将提供一种具有成本效益的预防策略，以避免CVD因其较高的护理成本而对患者生活质量和卫生系统产生负面影响。
