臨床検査58巻6号

2014年06月発行

今月の特集2 生理機能検査からみえる糖尿病合併症

糖尿病と関係する冠動脈疾患について

著者： 李政哲¹ 山崎力²

所属機関： ¹東京大学　循環器内科 ²東京大学　臨床研究支援センター

ページ範囲：P.740 - P.744

●糖尿病患者において，冠動脈疾患の罹患率は高い．

●無症状であることが多く，発見が難しい．

●冠動脈疾患は，重症であることが多い．

●冠動脈疾患治療後の予後は，非糖尿病患者と比べ悪い．

●無症候性糖尿病患者の冠疾患のスクリーニングは確立していない．

参考文献

1）Grundy SM, Benjamin IJ, Burke GL, et al：Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation　100：1134-1146，1999

2）National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)：Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation　106：3143-3421，2002

3）De Backer G, Ambrosioni E, Borch-Johnsen K, et al：European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J　24：1601-1610，2003

4）Haffner SM, Lehto S, Rönnemaa T, et al：Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med　339：229-234，1998

5）Fujishima M, Kiyohara Y, Kato I, et al：Diabetes and cardiovascular disease in a prospective population survey in Japan: The Hisayama Study. Diabetes　45（Suppl 3）：S14-S16，1996

6）Noda H, Iso H, Saito I, et al：The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study. Hypertens Res　32：289-298，2009

7）Tamaki J, Ueshima H, Hayakawa T, et al：Effect of conventional risk factors for excess cardiovascular death in men: NIPPON DATA80. Circ J　70：370-375，2006

8）Qiao Q, Pyörälä K, Pyörälä M, et al：Two-hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose. Eur Heart J　23：1267-1275，2002

9）Huxley R, Barzi F, Woodward M：Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ　332：73-78，2006

10）Eckel RH, Wassef M, Chait A, et al：Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group II: pathogenesis of atherosclerosis in diabetes. Circulation　105：e138-e143，2002

11）Adler AI, Stratton IM, Neil HA, et al：Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ　321：412-419，2000

12）Kawano H, Motoyama T, Hirashima O, et al：Hyperglycemia rapidly suppresses flow-mediated endothelium-dependent vasodilation of brachial artery. J Am Coll Cardiol　34：146-154，1999

13）Quiñones MJ, Hernandez-Pampaloni M, Schelbert H, et al：Coronary vasomotor abnormalities in insulin-resistant individuals. Ann Intern Med　140：700-708，2004

14）Hsueh WA, Lyon CJ, Quiñones MJ：Insulin resistance and the endothelium. Am J Med　117：109-117，2004

15）Mather KJ, Verma S, Anderson TJ：Improved endothelial function with metformin in type 2 diabetes mellitus. J Am Coll Cardiol　37：1344-1350，2001

16）Mullen MJ, Wright D, Donald AE, et al：Atorvastatin but not L-arginine improves endothelial function in type I diabetes mellitus: a double-blind study. J Am Coll Cardiol　36：410-416，2000

17）Skyrme-Jones RA, O’Brien RC, Berry KL, et al：Vitamin E supplementation improves endothelial function in type I diabetes mellitus: a randomized, placebo-controlled study. J Am Coll Cardiol　36：94-102，2000

18）Scognamiglio R, Negut C, Ramondo A, et al：Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. J Am Coll Cardiol　47：65-71，2006

19）Malmberg K, Yusuf S, Gerstein HC, et al：Impact of diabetes on long-term prognosis in patients with unstable angina and non-Q-wave myocardial infarction: results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) Registry. Circulation　102：1014-1019，2000

20）Elezi S, Kastrati A, Pache J, et al：Diabetes mellitus and the clinical and angiographic outcome after coronary stent placement. J Am Coll Cardiol　32：1866-1873，1998

21）Snader CE, Marwick TH, Pashkow FJ, et al：Importance of estimated functional capacity as a predictor of all-cause mortality among patients referred for exercise thallium single-photon emission computed tomography: report of 3,400 patients from a single center. J Am Coll Cardiol　30：641-648，1997

22）Bax JJ, Young LH, Frye RL, et al：Screening for coronary artery disease in patients with diabetes. Diabetes Care　30：2729-2736，2007