Dislipidemias e diabetes mellitus
fisiopatologia e tratamento
Palavras-chave:
Diabetes mellitus, Dislipidemias, Doenças cardiovascularesResumo
Inúmeros estudos demonstram que o diabetes mellitus é um fator de risco para doenças cardiovasculares. Sua associação à dislipidemia aumenta em duas a quatro vezes o risco de desenvolvimento de doenças cardiovasculares. Este artigo retrata a fisiopatologia da dislipidemia a partir de uma revisão bibliográfica, assim como as intervenções terapêuticas farmacológicas e não farmacológicas a serem adotadas, a fim de realizar-se prevenção das complicações cardiovasculares.
Downloads
Referências
Wingard DL, Barret-Connor E. family history of diabetes and cardiovascular disease risk factors and mortality among euglicemic, borderline hyperglycemic, and diabetic adults. Am J Epidemiol 1987; 125(6):948-58.
Wajchenberg BL. Disfunção endotelial no diabetes Arq Bras Endocrinol Metabol, 2002; 46(4):514-9.
Haffner SM. Management of dyslipidemia in adults with diabetes [Technical review], Diabetes Care, 1988 21:160-78.
Borggreve SE, De Vries R, Dullaart PP Alterations in high-density lipoprotein metabolism and reverse cholesterol transport in insulin resistance and type 2 diabetes mellitus-. role of lipolytic enzymes, lecithin cholesterol acyl transferase and lipid trasfer proteins Eur J Clin Invest. 2003; 33(12):1051-69.
Goldberg IJ, Diabetic dyslipidemia: causes and consequences. J Clin Endocrinol Metabol. 2001; 86(3):965-70.
Gardner CD, Fortmann SP, Krauss RM. Association of small low-densit lipoprotein particles with the incidence of coronary artery disease in men and women. Jama. 1996; 276(11):875-81.
Rhodes CJ, White MF. Molecular insights into insulin action and secretion. Eur J Clin Inves. 2002; 32(3):3-13.
Montagnani M, Ravichandran LV, Chen H, et al. Insulin stimulated activatton of eNOS is independent of CA2+
but requires phosphorylacion by Akt at Ser (1179). J Biol Chem, 2001 ; 276(32):30392-8.
Chen H, Montagnani M, Funahashi T. Adiponectin stimulates production of nitric oxide tn endotelial cells throug AMPK-dependent phosphorylation of eNOS at Ser 1179. Diabetes. 2003; 53(2):1839-45.
Mineo C, Yuhanna IS, Quon MJ, Shaul PW. High density lipoprotein-induce endothelial nitric-oxide synthase activation is mediated by Akt and MAP kinases. J Biol Chem. 2003; 278(11):9142-9.
Pittas AG, Joseph NA, Greensberg AS. Adipocytokines and insulin resistance. J Clin Endocrinol Metabol 2004; 89(2):447-52.
Turner RC, Millns H, Neil HAW, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ. 1998; 316(7134):823-8.
Brown AS. Lipid management in patients with diabetes mellitus . Am J Cardiol. 2005; 96(Suppl):26E-32E.
Tuomilehto J. Lindstron J, Eriksson JG, Valle TT, Hamalainen H. lllanne Parikka Y. et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subtects with impaired glucose tolerance. N Engl J Med. 2001, 344(18):1343-50.
American Diabetes Association. Physical Activity/Exercise and diabetes [Position Statement]. Diabetes Care. 2004; 27(1):58-62.
American Diabetes Association. Nutrition principles and recommendations in diabetes [Position Statements]. Diabetes Care. 2004; 27(1):36-65.
The diabetes and nutrition study group (DNSG) of the European Association for the Study of Diabetes (EASD). Recommendations for the nutricional management of patients with diabetes mellitus. Eur J CFin Nutr. 2000; 3(12):725-31.
Krauss RM, Eckel RH, Howard B. AHA dietary guidelines: revision 2000 a statement for health care professionals from the Nutrition Committee. Am Heart Assoc Circ. 2000; 102(18):2284-99.
Dietary supplementation with N-3 polyunsaturated fatty acids and vitamin E after myocardial infarction results ot the GISSt-Prevenzione Trial. Gruppo italiano per lo Studio Della Sopravvivenza nell Infarto Miocardio. Lancet. 1999, 354(9177):447-55.
Adler AI, Stevens RJ, Neil A, Stratton IM, Boulton AJ, Holman RR, et al. For UK. Prospective Diabetes Study Group, U KPDS 59: Hyperglycemia and other potentially modificable risk factor for periferical vascular disease in type 2 diabetes. Diabetes Care 2002; 25(5):894-9.
Stevens RJ. Coleman RL, Adler AI, Stratton IM, Matthews DR, Holman RR. Risk factors for myocardial infarction case fatality and stroke case fatality in type diabetes (UKPDS 66). Diabetes Care. 2004; 27(1):201-7.
DECODE Study Group on Behalf of the European Diabetes Epidemiology Group. is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular disease. Diabetes Care. 2003; 26(3):688-96.
Desfaits AC. Serri O, Renier G. Normalization of plasma lipid peroxides monocytes adhesion. and tumor necrosis factor production in niddm patientes after gliclazide Treatment. Diabetes Care. 1998; 21 (4):487-93.
Effects of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes: UKPDS 34. Lancet. 1998; 352(9131):854-65.
Abassi F, Chu JW, McLaughltn T, Lamendola O, Leary ET. Reaven GM. Effect of metformin treatment on multiple cardiovascular disease risk factors in patients with type 2 diabetes mellitus . Metabolism. 2004; 53(2):1 59-64.
Chiasson JL, Jose RG. Gomis R, Manefeld M, Karasik A, Laakso M. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance. The STOP-NIDDM
Trial. Jama. 2003; 290(4):486-94.
Mimura K, Umeda, Hiramatsu S, Tanigushi S, Onoy N, et al, Effects of a new oral hypoglycaemic agent (CSO45) on metabolic abnormalities and insulin resistance in type 2 diabetes. Diabetes Metab. 1994; 11 (7):685-91.
Gerich JE. Redefining the clinical management of type 2 diabetes: matching therapy to pathophysiofogy. Eur J Clin Invest. 2002; 32(3):46-53.
Hsueh WA, Law RE: PPAFR gamma and ahtroesclerosis effects on the cell gowth and movement. Aterioscler Thromb Vasc Biol. 2001; 21 (12):1891-5.
Guo Q, Sahoo SP, Wang PR, Milot DP, lppolito MC, WU MS, et al. A novel perixome proliferator activated receptor alpha/gamma dual agonist demonstrates favorable effects on lipid homeostasis. Endocrinology. 2004; 145(4): 1 640-8.
Olansky L, Maichetti A, Lay H, Multicenter retrospective assessment of thiazolidinedione monotherapy and combination therapy in patients with type 2 diabetes: comparative subgroup analyses of glycemic control and blood lipid levels. Clin Ther, 2003; 25(B):64-80.
Einhorn D, Rendell M, Rosenzweig J, Egan JW, Mathisen AI, Schneider RL, Pioglitazone hydrochloride in combination with merformin in the treatment of type 2 diabetes mellitus-. a randomized, placebocontrolled study. The Pioglitazone 027 Study Group. Clin Ther. 2000; 22(12):1395-409.
Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial in macroVascular Events): a randomtsed controfled trial. American Diabetes Association: dyslipidemia management in adults with diabetes (Position Statement). Diabetes Care. 2004; 27(1):68-71.
Collins R, Armitage J, Parish S, Sleigh P, Peto R, MCR/BHF heart protection study of cholesterol-lowering with simvastatin in 5.963 people with diabetes: a radomised placebo controlled trial. Lancet. 2003; 361 (9374):2205-16.
Pyorala K, Pedersen TR, Kje Kshus J, Faergeman O. Olsson AG, Thorgeirsson G. Chofesterol lowering with simvastatin improves prognosis of diabettc patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care. 1997; 20(4):614-20.
Goldberg RB, Mellies MJ, Sacks FM, Moyé LA, Howard BV, Howard WJ. et al. Cardiovascular events and their reduction with pravastatin in diabetic and glucoseintolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the cholesterol and recurrent events (CARE) trial. Circulation. 1998; 98(23):2513-9.
Colhoun HM, Betteridge DJ, Durrington PN, et al Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomized placebo-controlled trial. Lancet. 2004 364(9435):685-96.
McKenney JM, Jones PH, Adamczyk MA, Cain VA, Bryzinski BS, Blasetto JW. Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals results from the STELLAR trial. Curr Med Res Opin 2003; 19(8):689-98.
Mannien v, Tenkanen L, Koskinen P. Huttunen JK. Maãnttäri M, Heinonen OE et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Impl Treatment Circulation 1992; 85(1)37-45.
Robins SJ, Rubins HB, Faas FH, Schaefer EJ. Elam MB Anderson JW, et al. Insulin resistance and cardiovascular events with low HDL cholesterol: the Veterans Affairs HDL intervention trial (VA-HIT) Diabetes Care, 2003; 26(5):1513-7
Keech A, Simes RJ, Barter P. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study) randomized controlled trial. The FIELD investigators. Lancet. 2005; 366(9500):1849-61.
Haffner SM, Lehto S, Ronemaat, Pyorala K, Laakso M Mortality from coronary heart disease in subjects with type 2, diabetes and nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339(4):229-34
