胰岛素抵抗、糖尿病与冠心病(英文)

胰岛素抵抗、糖尿病与冠心病(英文)

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

2、sMellitusandHyperglycemiaPlasmaGlucoseConcentration>7.0(>126)>6.1(>110)to<7.0(<126)2-HourPost GlucoseLoadFasting GlucoseDiabetesMellitusImpairedGlucoseToleranceImpairedFastingGlucose>11.1(>200)>7.8(>140)to <11.1(<200)Valuesaremmol/L(mg/dl)DevelopedDevelopingPercentKing

3、Hetal.DiabetesCare1998;21:1414-1431.World1995PrevalenceofDiabetesinAdultPopulation (Aged>20years)byYearandRegion20002025HospitalizationCostsforChronicComplicationsofDiabetesintheUSAmericanDiabetesAssociation.EconomicConsequencesofDiabetesMellitusintheUSin1997.Alexandri

4、a,VA:AmericanDiabetesAssociation,1998:1-14.Totalcosts12billionUS$CVDaccountsfor64%oftotalcostsOthersOphthalmic diseaseCardiovascular diseaseRenal diseaseNeurologicdiseasePeripheral vascular diseaseAnnualCHDDeathsper1000PersonsKannelWB,McGeeDL.JAMA1979;241:2035-2038.Fra

5、minghamStudy:DMandCHDMortality20-YearFollow-up178174MenWomenDMNon-DMIschemicheart disease%ofDeathsGeissLSetal.In:DiabetesinAmerica.2nded.1995;chap11.MortalityinPeoplewithDiabetesCausesofDeathOther heart diseaseDiabetesCancerStrokeInfectionOtherMortalityper1000 person-y

6、ears**Age-adjustedAdaptedfromGuKetal.DiabetesCare1998;21:1138-1145.MortalityDuetoHeartDiseaseinMenandWomenwithorwithoutDiabetes(US)29.919.2MenWomenDiabetesNoDiabetesAllheartdiseaseIschemicheartdiseaseMenWomen11.56.323.07.111.03.6NondiabetesDiabetes*Definedin1971-1975,f

7、ollowedupthrough1982-1984. **Definedin1982-1984,followedupthrough1992-1993.GuKetal.JAMA1999;281:1291-1297.TrendsinMortalityRatesforIschemicHeartDiseaseinNHANESSubjectswithandwithoutDiabetes*17.06.8-16.6%+10.7%Men,cohort1*Men,cohort2**Women,cohort1*Women,cohort2**-43.8%

8、-20.4%14.27.67.44.22.41.9(P=0.46)(P=0.76)(P<0.001)(P=0.12)Rateper1000person-yearsWOMENMENSurvivalPost-MIinDiabeticand

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