Predicting Cardiovascular Risk in Type 2 Diabetes: the Heterogeneity Challenges
Predicting Cardiovascular Risk in Type 2 Diabetes: the Heterogeneity Challenges
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DOI：
10.1007/s11886-015-0607-7
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发表时间：
2015-07-01
影响因子：
3.7
通讯作者：
Rosenstock, Julio
中科院分区：
文献类型：
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作者：
Gore, M. Odette;McGuire, Darren K.;Rosenstock, Julio
2型糖尿病在世界范围内已达到流行病的比例，并且归因于糖尿病的心血管风险的增加估计在2至4倍的范围内，这构成了严重的公共卫生问题。虽然在某些情况下，2型糖尿病已等同于冠心病等效风险，但有相当多的证据表明，心血管风险增加并不均匀地影响所有2型糖尿病患者。心血管风险的这种异质性是多因素的，并且仅部分了解，但对于我们了解糖尿病和心血管疾病的关系以及制定最佳和个性化的心血管风险降低策略来说是一个关键考虑因素。本文综述了糖尿病心血管风险异质性的概念，包括流行病学证据，异质性的既定和潜在决定因素的讨论，以及临床，研究和监管的影响。
Type 2 diabetes mellitus has reached epidemic proportions around the world, and the increase in cardiovascular risk attributable to diabetes estimated to range from 2- to 4-fold poses grave public health concern. Though in some contexts type 2 diabetes has been equated with coronary heart disease equivalent risk, there is considerable evidence that incremental cardiovascular risk does not uniformly affect all people with type 2 diabetes. This heterogeneity in cardiovascular risk is multifactorial and only partially understood but is a key consideration for our understanding of the nexus of diabetes and cardiovascular disease and for the development of optimal and individualized cardiovascular risk reduction strategies. This review provides a brief synopsis of the concept of cardiovascular risk heterogeneity in diabetes, including epidemiologic evidence, discussion of established and potential determinants of heterogeneity, and clinical, research, and regulatory implications.