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Effect of glycemic control on markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus:A review

查看全文 作　　者：Sofia [1]Antoniou;Katerina K K [2]Naka;Marios [3]Papadakis;Aris [2]Bechlioulis;Agathocles [1]Tsatsoulis;Lampros K [2]Michalis;Stelios [1]Tigas 高影响力作者 机构地区：[1]Department of Endocrinology,University of Ioannina,Ioannina 45110,Greece;[2]2^(nd)Department of Cardiology and Michaelidion Cardiac Center,University of Ioannina,Ioannina 45110,Greece;[3]Department of SurgeryⅡ,University of Witten-Herdecke,Wuppertal 42283,Germany高影响力机构 出　　处：《World Journal of Diabetes》索引2021年第12卷第11期,共19页高影响力期刊 摘　　要：Cardiovascular disease is the predominant cause of death in type 2 diabetes mellitus(T2DM).Evidence suggests a strong association between duration and degree of hyperglycemia and vascular disease.However,large trials failed to show cardiovascular benefit after intensive glycemic control,especially in patients with longer diabetes duration.Atherosclerosis is a chronic and progressive disease,with a long asymptomatic phase.Subclinical atherosclerosis,which is impaired in T2DM,includes impaired vasodilation,increased coronary artery calcification(CAC),carotid intima media thickness,arterial stiffness,and reduced arterial elasticity.Each of these alterations is represented by a marker of subclinical atherosclerosis,offering a cost-effective alternative compared to classic cardiac imaging.Their additional use on top of traditional risk assessment strengthens the predictive risk for developing coronary artery disease(CAD).We,herein,review the existing literature on the effect of glycemic control on each of these markers separately.Effective glycemic control,especially in earlier stages of the disease,attenuates progression of structural markers like intima-media thickness and CAC.Functional markers are improved after use of newer antidiabetic agents,such as incretin-based treatments or sodium-glucose cotransporter-2 inhibitors,especially in T2DM patients with shorter disease duration.Larger prospective trials are needed to enhance causal inferences of glycemic control on clinical endpoints of CAD. 关 键 词：Glycemic control ATHEROSCLEROSIS Type 2 diabetes mellitus Cardiovascular disease Carotid intima media thickness
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