Impaired glucose tolerance and cardiovascular disease: The possible role of post-prandial hyperglycemia
Impaired glucose tolerance and cardiovascular disease: The possible role of post-prandial hyperglycemia
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DOI：
10.1016/j.ahj.2003.11.020
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发表时间：
2004-05-01
影响因子：
4.8
通讯作者：
Ceriello, A
中科院分区：
文献类型：
--
作者：
Ceriello, A
越来越多的证据表明，餐后状态是动脉粥样硬化发展的重要因素。在糖耐量受损受试者中，尽管空腹血糖在参考范围内，但餐后阶段的特征是血糖水平快速大幅升高。这种餐后“高血糖峰”可能与这些受试者的心血管疾病的发展有关的可能性最近受到了很多关注。口服葡萄糖耐量试验，虽然高度非生理性，但已被大量用作餐后状态的模型，并且流行病学研究表明，口服葡萄糖耐量受损与心血管疾病风险增加相关，因为葡萄糖激发2小时后的血糖水平是直接和独立的风险因素。大多数心血管危险因素在餐后阶段发生改变，并直接受到急性增加的心血管疾病的影响。急性高血糖症发挥其作用的机制可以在自由基的产生中确定，自由基有利于内皮功能障碍、血栓形成前和促炎性疾病的发展。未来的研究可能会评估纠正糖耐量受损状态下的餐后高血糖是否可以成为这些受试者心血管疾病预防和管理策略的一部分。
There is increasing evidence that the post-prandial state is an important contributing factor in the development of atherosclerosis. In subjects with impaired glucose tolerance, whereas fasting glycemia is in reference range, the post-prandial phase is characterized by a rapid and large increase in blood glucose levels. The possibility that this post-prandial "hyperglycemic spike" may be relevant to the development of cardiovascular disease in these subjects has received recently much attention. The oral glucose tolerance test, although highly non-physiological, has been used largely as model of the post-prandial state, and epidemiological studies have shown that impaired oral glucose tolerance is associated with an increased risk of cardiovascular disease, because the glycemia level after 2 hours of the glucose challenge is a direct and independent risk factor. Most of the cardiovascular risk factors are modified in the post-prandial phase and are directly affected by an acute increase of glycemia. The mechanisms through which acute hyperglycemia exerts its effects may be identified in the production of free radicals, which favours the development of an endothelial dysfunction, a prothrombotic and proinflammatory condition. Future studies may evaluate whether correcting the post-prandial hyperglycemia in the impaired glucose tolerance state can form part of the strategy for the prevention and management of cardiovascular diseases in these subjects.