糖尿病对心血管危险的影响幻灯片.pptVIP

Impact of Diabetes on Cardiovascular Risk C.Richard Conti M.D. MACC Oct 16,2004 GWICC Beijing, PRC Diabetes and Cardiovascular Risk An Association between diabetes mellitus and angina pectoris was first described in 1883, shortly after it was hypothesized that angina pectoris was due to atherosclerosis Vergely P. De l’angine de poitrine dans ses rapports avec le diabete. Gaz hedb de ned (ser 2) 1883;20:364 * Image ?(Prevention/Vascular) Overlap of Four Common Conditions 25 KB???File Type: GIF ? ????  ? ACCEL?image provided by the American College of Cardiology Foundation ? Source Clinical Trial (INVEST)Blood Pressure Control NCEP (ATP III) Definition of Metabolic Syndrome 3 of these 5 factors have to be present: Increased waist circumference (102 cm in men or 88 cm in women) Hypertriglyceridemia (150 mg/dl) Low HDL-cholesterol (40 mg/ml in men and 50 mg/ml in women) Hypertension (BP 130/80 mm Hg) Fasting serum glucose 110 mg/dl (Validated with the WOSCOPS data) ? Image ? Abnormalities Associated With the Metabolic Syndrome114 KB???File Type: JPG ? ????  ? ACCEL?image provided by the American College of Cardiology Foundation ? Source IGT Insulin resistance Increased insulinresistance Fasting glucose Hyperglycemia Insulin secretion Hyperinsulinemia, then b-cell failure Adapted from International Diabetes Center (IDC), Minneapolis, Minnesota Insulin Resistance and ?-Cell Dysfunction Are Fundamental to Type 2 Diabetes Post-prandial glucose Abnormal glucose tolerance Normal Type 2 Diabetes 50% of Type 2 Diabetes Patients Have Complications at the Time of Diagnosis Retinopathy, glaucoma or cataracts Nephropathy Neuropathy MICROVASCULAR MACROVASCULAR Cerebrovascular disease Coronary heart disease Peripheral vascular disease UK Prospective Diabetes Study Group. UKPDS 33. Lancet 1998; 352: 837–853 Microalbuminuria in Metabolic Syndrome (MS) Patients Microalbuminuria mg/24h p =