糖尿病与心血管疾病69541 ppt课件.ppt

* Key Points Weight losses of 5% to 10% have been shown to have a significant impact on several aspects of the metabolic syndrome, including well-recognized risk factors for cardiovascular disease and diabetes. For example, Wing and colleagues at Brown University evaluated the effect of modest weight loss in 114 patients with type 2 diabetes. Those who lost 5% or more of their baseline weight showed statistically significant decreases in serum HbA1c levels. The Trial of Antihypertensive Interventions and Management Study found that weight losses of 5% or more produced reductions in diastolic pressure that were equivalent to those produced by a single dose of antihypertensive medication. Numerous studies have shown that weight losses of 5%-10% improve total cholesterol, LDL-to-HDL ratio, and the ratio of total-to-HDL cholesterol. In one study, weight reduction of just 5.8% was associated with a 16% reduction in total cholesterol, an 18% increase in HDL cholesterol, and a 12% decrease in LDL cholesterol. Wing RR et al. Long-term effects of modest weight loss in Type 2 diabetic patients. Arch Intern Med 1987;147:1749-53. Blackburn G. Effect of degree of weight loss on health benefits. Obes Res 1995;3 (Suppl 2):211S-16S. Ditschunheit HH et al. Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects Eur J Clin Nutr 2002;56:264-70. Mertens IL, Van Gaal LF. Overweight, obesity, and blood pressure: The effects of modest weight reduction. Obes Res 2000;8:270-8. * * * * * Key Points Potential targets for measurement include: ? Pro-inflammatory risk factors such as oxidized low-density lipoproteins ? Pro-inflammatory cytokines (e.g. interleukin-1, tumour necrosis factor-?) ? Adhesion molecules (e.g. intercellular adhesion molecule-1, selectins) ? Inflammatory stimuli with hepatic effects (e.g. interleukin-6) or the products of the hepatic stimulation, such as SAA, C-reactive protein (CRP), and a host of other acute-pha