胰岛素抵抗、糖尿病与冠心病PPT课件.ppt

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1、EpidemiologyofInsulinResistance,DiabetesMellitus,andCoronaryHeartDiseaseStevenHaffner,MDAdaptedfromWorldHealthOrganization.Definition,DiagnosisandClassificationofDiabetesMellitusanditsComplications.Geneva:WorldHealthOrganization:1999:52.CriteriafortheDiagnosisofDiabetesMellitusandHy

2、perglycemiaPlasmaGlucoseConcentration>7.0(>126)>6.1(>110)to<7.0(<126)2-HourPostGlucoseLoadFastingGlucoseDiabetesMellitusImpairedGlucoseToleranceImpairedFastingGlucose>11.1(>200)>7.8(>140)to<11.1(<200)Valuesaremmol/L(mg/dl)DevelopedDevelopingPercentKingHetal.DiabetesCare1998;21:14

3、14-1431.World1995PrevalenceofDiabetesinAdultPopulation(Aged>20years)byYearandRegion20002025HospitalizationCostsforChronicComplicationsofDiabetesintheUSAmericanDiabetesAssociation.EconomicConsequencesofDiabetesMellitusintheUSin1997.Alexandria,VA:AmericanDiabetesAssociation,1998:1-14

4、.Totalcosts12billionUS$CVDaccountsfor64%oftotalcostsOthersOphthalmicdiseaseCardiovasculardiseaseRenaldiseaseNeurologicdiseasePeripheralvasculardiseaseAnnualCHDDeathsper1000PersonsKannelWB,McGeeDL.JAMA1979;241:2035-2038.FraminghamStudy:DMandCHDMortality20-YearFollow-up178174MenW

5、omenDMNon-DMIschemicheartdisease%ofDeathsGeissLSetal.In:DiabetesinAmerica.2nded.1995;chap11.MortalityinPeoplewithDiabetesCausesofDeathOtherheartdiseaseDiabetesCancerStrokeInfectionOtherMortalityper1000person-years**Age-adjustedAdaptedfromGuKetal.DiabetesCare1998;21:1138-1145.Mor

6、talityDuetoHeartDiseaseinMenandWomenwithorwithoutDiabetes(US)29.919.2MenWomenDiabetesNoDiabetesAllheartdiseaseIschemicheartdiseaseMenWomen11.56.323.07.111.03.6NondiabetesDiabetes*Definedin1971-1975,followedupthrough1982-1984.**Definedin1982-1984,followedupthrough1992-1993.GuKetal.J

7、AMA1999;281:1291-1297.TrendsinMortalityRatesforIschemicHeartDiseaseinNHANESSubjectswithandwithoutDiabetes*17.06.8-16.6%+10.7%Men,cohort1*Men,cohort2**Women,cohort1*Women,cohort2**-43.8%-20.4%14.27.67.44.22.41.9(P=0.46)(P=0.76)(P<0.001)(P=0.12)Rateper1000person-yearsWOMENMENSurvivalP

8、ost-MIinDiabeticand