School of Medicine, Royal College of Surgeons in Ireland and Medical University of Bahrain, Busaiteen 15503, Bahrain.
Research Department, Royal College of Surgeons in Ireland and Medical University of Bahrain, Busaiteen 15503, Bahrain.
Biomolecules. 2023 Jan 27;13(2):241. doi: 10.3390/biom13020241.
Cardiovascular diseases (CVDs) are the leading cause of death globally as well as the leading cause of mortality and morbidity in type 2 diabetes (T2D) patients. Results from large interventional studies have suggested hyperglycemia and poor glycemic control to be largely responsible for the development of CVDs. However, the association between hypoglycemia and cardiovascular events is also a key pathophysiological factor in the development of CVDs. Hypoglycemia is especially prevalent in T2D patients treated with oral sulfonylurea agents or exogenous insulin, increasing the susceptibility of this population to cardiovascular events. The adverse cardiovascular risk of hypoglycemia can persist even after the blood glucose levels have been normalized. Hypoglycemia may lead to vascular disease through mechanisms such as enhanced coagulation, oxidative stress, vascular inflammation, endothelial dysfunction, and platelet activation. In the following review, we summarize the evidence for the role of hypoglycemia in platelet activation and the subsequent effects this may have on the development of CVD. In addition, we review current evidence for the effectiveness of therapies in reducing the risk of CVDs.
心血管疾病（CVDs）是全球范围内的主要死亡原因，也是 2 型糖尿病（T2D）患者死亡和发病的主要原因。来自大型干预性研究的结果表明，高血糖和血糖控制不佳是 CVDs 发展的主要原因。然而，低血糖与心血管事件之间的关联也是 CVDs 发展的关键病理生理因素。低血糖在接受口服磺脲类药物或外源性胰岛素治疗的 T2D 患者中尤为常见，增加了该人群发生心血管事件的易感性。即使血糖水平恢复正常，低血糖的不良心血管风险仍可能持续存在。低血糖可能通过增强凝血、氧化应激、血管炎症、内皮功能障碍和血小板激活等机制导致血管疾病。在以下综述中，我们总结了低血糖在血小板激活中的作用及其对 CVD 发展的后续影响的证据。此外，我们还回顾了目前降低 CVD 风险的治疗方法的有效性证据。
