血糖異常與心血管疾病

Dysglycemia and Cardiovascular Disease

塗宜育(Yi-Yu Tu) ； 許惠恒(Wayne Huey-Herng Sheu)

《內科學誌》 19卷4期 (2008/08) Pp. 289-296

https://doi.org/10.6314/JIMT.2008.19(4).02

摘要

血糖異常(dysglycemia)之機會會隨著年齡增加而增加，事實上糖尿病(diabetes mellitus)和葡萄糖失耐(impaired glucose tolerance)的盛行率隨著年齡增加而增加。相較於血糖正常的人，葡萄糖耐受性異常者其罹患心血管疾病(Cardiovascular disease)的風險和死亡率會顯著增加，尤其是餐後血糖異常與罹患心血管疾病風險的增加具有明顯的相關性。此外，在大部分的心血管疾病患者，不論是急性心肌梗塞(acute myocardial infarction)或不穩定心絞痛(unstable angina pectoris)的心臟血管疾病患者，亦或是腦血管疾病(cerebrovascular disease)患者，在發病時一半以上都已同時合併有血糖代謝異常情形，其中部分是以餐後血糖升高爲主。對於此些患者，應接受生活方式的改變、運動和飲食控制或接受藥物治療來減少或延緩得到第2型糖尿病的機會。依據歐洲心臟學會(ESC, European Society of Cardiology)和歐洲糖尿病研究學會(EASD, European Association for the Study of Diabetes)共同公佈的最新的治療指引，對於血糖異常者應積極改善其餐後血糖異常，以降低未來再發生心血管疾病的風險和死亡率。

關鍵字

空腹血糖偏高 ； 葡萄糖失耐 ； 糖尿病前期 ； 心血管疾病 ； 腦血管疾病

並列摘要

Dysglycemia usually increases with age. In fact, the prevailing rate of diabetes and impaired glucose tolerance shows an increase with age. Epidemiological data revealed that the risk and mortality rate for cardiovascular diseases in individuals with glucose intolerance is higher than in individuals with normal blood glucose, and there is an obvious relationship with postprandial hyperglycemia. In addition, more than half of the patients with cardiovascular diseases, whether they have acute myocardial infarction, unstable angina pectoris or cerebrovascular disease, already have metabolic disorder of blood glucose and part of them have postprandial hyperglycemia. Those who are at high risks for type 2 diabetes and/or cardiovascular diseases need lifestyle intervention, exercise, and diet modification or medication which reduce postprandial glucose and improve insulin sensitivity. According to the latest guidelines from the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD), subjects with postprandial hyperglycemia should be treated aggressively to reduce the mortality rate and the recurrence of cardiovascular risk.

並列關鍵字

Impaired fasting glucose ； Impaired glucose tolerance ； Pre-diabetes ； Cardiovascular disease ； Cerebrovascular disease