Syndrome Diabetes and Cardiovascular 代谢综合征糖尿病心血管疾病课件.pptVIP

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Syndrome Diabetes and Cardiovascular 代谢综合征糖尿病心血管疾病课件.ppt

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Syndrome Diabetes and Cardiovascular 代谢综合征糖尿病心血管疾病课件

* This population-based study compared the 7-year incidence of fatal and nonfatal MI among subjects with and without type 2 diabetes. A?history of MI at baseline in either group was significantly associated with an increased incidence of fatal and nonfatal MI (P0.001). Subjects with neither diabetes nor prior MI had the best prognosis (3.5% incidence of MI); subjects with both diabetes and prior MI had the worst prognosis (45% incidence of MI). Those patients with type 2 diabetes and no prior history of MI had intermediate survival rates, similar to patients without diabetes but with a history of MI (20.2% and 18.8%, respectively, after adjustments for age and sex). Coronary disease incidence rates were also similar between these two groups. These findings suggest that all patients with diabetes should be treated as if they had prior MI, ie, should be treated aggressively. Haffner SM, et al. N Engl J Med. 1998;339:229–234. * Insulin resistance is a precursor to a variety of metabolic abnormalities, including systemic inflammation, visceral obesity, and type 2 diabetes. Insulin resistance is also a risk factor for cardiovascular abnormalities, including hypertension, dyslipidemia (increased triglycerides and LDL and decreased HDL), disordered fibrinolysis, and endothelial dysfunction. All of these aberrations contribute to the atherosclerotic process. Consensus Development Conference of the American Diabetes Association. Diabetes Care. 1998;21:310-314. Pradhan AD et al. JAMA. 2001;286:327-334. * Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA. 2001;285:2486-2497; Updated AHA/NHLBI Statement Oct 18, 2005: Grundy et al. Circulation 2005; 112 (epub). * * Circling back to the discussion of abdominal adiposity, data regarding waist circumference and diabetes illustrate its health impact. These are age-adjusted data from the Nurses’ Health Study, analyzing responses from 43,581 subjects who provided information on wei