Doms № 5 -2022

Цукровий діабет та інсульт

Маньковський Б. М.

https://doi.org/10.57105-2415-7252-2022-5-05

Резюме

Гострі порушення церебрального кровообігу (інсульти) — одні з давно відомих ускладнень цукрового діабету, які, поряд з іншими макросудинними ускладненнями, як-от інфаркт міокарда, ураження периферійних артерій, є основною причиною смертності пацієнтів з цукровим діабетом 2-го типу. Інсульти є третьою за значенням причиною смертності в економічно розвинених країнах Європи й Північної Америки. Попри великі зусилля, прикладені для зниження ризику інсультів у багатьох розвинених країнах світу, збільшення тривалості життя й зростання поширеності факторів ризику розвитку інсульту (серед яких цукровий діабет відіграє одну з головних ролей) призвели до того, що ймовірність захворюваності інсультом протягом життя, навпаки, зросла з 22,8 % у 1990 році до 24,9 % у 2016 році. В цьому огляді, що базується на аналізі сучасних досліджень, розглядаються питання етіології, патогенезу ти фактори ризику інсультів у пацієнтів з цукровим діабетом.

Ключові слова: інсульт, смертність, фактори ризику інсультів, цукровий діабет

 

 

Література:

  • American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care. 2021; 44, Supplement 1: S1-S232.
  • Wafa HA, Wolfe CDA, Emmett E, et al. Burden of Stroke in Europe: Thirty-Year Projections of Incidence, Prevalence, Deaths, and Disability-Adjusted Life Years. Stroke. 2020;51(8):2418-2427.
  • European Society of Cardiology, 2019, Meeting Proceedings.
  • Norrving B, Kissela B. The global burden of stroke and need for a continuum of care. Neurology. 2013;80: S5-12.
  • American Heart Association, Meeting proceedings, 2020.
  1. O’Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376(9735):112-123.
  • Zareini B, Blanche P, D’Souza M, et al. Type 2 Diabetes Mellitus and Impact of Heart Failure on Prognosis Compared to Other Cardiovascular Diseases: A Nationwide Study. Circ Cardiovasc Qual Outcomes. 2020;13(7):e006260. doi: 10.1161/CIRCOUTCOMES.119.006260.
  • Stegmayr B, Asplund K. Diabetes as a risk factor for stroke. A population perspective. 1995; 38: 1061-1068.
  • Folsom AR, Rasmussen ML, Chambless ME, et al. Prospective associations of fasting insulin, body fat distribution, and diabetes with risk of ischemic stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Diabetes Care. 1999; 22: 1077-1083.
  • Kissela BM, Khoury J, Kleindorfer D, et al. Epidemiology of ischemic stroke in patients with diabetes: the greater Cincinnati/Northern Kentucky Stroke Study. Diabetes Care. 2005;28: 355-359.
  • Danaei G, Lawes CM, Van der Hoorn, et al. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. Lancet. 2006; 368: 1651-1659.
  • Currie CJ, Morgan CL, Gill L, et al. Epidemiology and costs of acute hospital care for cerebrovascular disease in diabetic and nondiabetic populations. Stroke. 1997; 28:1142-1146.
  • Ho JE, Paultre F, Mosca L for the Women’s Pooling Project. Is diabetes mellitus a cardiovascular disease risk equivalent for fatal stroke in women? Data from the Women’s Pooling Project. Stroke. 2003; 34: 2812-2816.
  • Hu G, Jousilahti P, Sarti C, et al. The effect of diabetes and stroke at baseline and during follow-up on stroke mortality. Diabetologia. 2006; 49: 2309-2316.
  • Mulnier HE, Seaman HE, Raleigh VS, et al. Risk of stroke in people with type 2 diabetes in the UK: a study using the General Practice Research Database. Diabetologia 2006; 49: 2859-2865.
  1. Schramm TK, Gislason GH, Køber L, et al. Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people. Circulation. 2008; 117: 1945-1954.
  2. Gray CS, Scott JF, French JM, et al. Prevalence and prediction of unrecognised diabetes mellitus and impaired glucose tolerance following acute stroke. Age Ageing. 2004;33(1):71-77.
  • Ivey FM, Ryan AS, Hafer-Macko CE, et al. High prevalence of abnormal glucose metabolism and poor sensitivity of fasting plasma glucose in the chronic phase of stroke. Cerebrovasc Dis. 2006;22(5-6):368-371.
  • Matz K, Keresztes K, Tatschl C, et al. Disorders of glucose metabolism in acute stroke patients: an underrecognized problem. Diabetes Care. 2006;29(4):792-797.
  • Peters SA, Huxley RR, Woodward M. Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775,385 individuals and 12,539 strokes. Lancet. 2014;383(9933):1973-1980.
  • Janghorbani M, Hu FB, Willett WC, et al. Prospective study of type 1 and type 2 diabetes and risk of stroke subtypes: the Nurses’ Health Study. Diabetes Care. 2007; 30:1730-1735.
  • Fuller JH, Stevens LK, Wang SL, and the WHO Multinational Study Group. Risk factors for cardiovascular mortality and morbidity: The WHO multinational study of vascular disease in diabetes. Diabetologia. 2001; 44: 54-64.
  1. Laing SP, Swerdlow AJ, Carpenter LM et al. Mortality from cerebrovascular disease in a cohort of 23 000 patients with insulin-treated diabetes. Stroke. 2003; 34: 418-421.
  • Jeerakathil T, Johnson JA, Simpson SH, Majumdar SR Short-term risk for stroke is doubled in persons with newly treated type 2 diabetes compared with persons without diabetes: a population-based cohort study. Stroke. 2007; 38: 1739-1743.
  • Nanayakkara N, Curtis AJ, Heritier Set al. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia. 2021; 64(2): 275-287.
  • Niskanen L, Turpeinen A, Penttila I, Uusitupa MI. Hyperglycemia and compositional lipoprotein abnormalities as predictors of cardiovascular mortality in type 2 diabetes: a 15-year follow-up from the time of diagnosis. Diabetes Care. 1998;21: 1861-1869.
  • Abu-Lebdeh HS, Hodge DO, Nguyen TT. Predictors of macrovascular disease in patients with type 2 diabetes mellitus. Mayo Clin Proc. 2001; 76: 707-712.
  • Selvin E, Coresh J, Shahar E et al. Glycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Lancet Neurol 2005; 4: 821-826.
  • Selvin E, Marinopoulos S, Berkenblit G, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004; 141: 421-431.
  • Stevens RJ, Coleman RL, Adler AI, et al. Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes: UKPDS 66. Diabetes Care. 2004; 27: 201-207.
  • Moss SE, Klein R, Klein BEK, Meuer SM. The association of glycemia and cause-specific mortality in diabetic population. Arch Intern Med. 1994; 154: 2473-2479.
  • Lowe LP, Liu K, Greenland P, et al. Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men. The Chicago Heart Association Detection Project in Industry Study. Diabetes Care. 1997; 20: 163-169.
  • Kothari V, Stevens RJ, Adler AI, et al. UKPDS 60: risk of stroke in type 2 diabetes estimated by the UK Prospective Diabetes Study risk engine. Stroke. 2002;33(7):1776-1781.
  • Balkau B, Shipley M, Jarrett RJ, et al. High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men. 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study. Diabetes Care. 1998;21(3):360-367.
  • DECODE Study Group, the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria .Arch Intern Med. 2001;161(3): 397-405.
  • Benn M, Emanuelsson F, Tybjærg-Hansen A, Nordestgaard BG. Impact of high glucose levels and glucose lowering on risk of ischaemic stroke: a Mendelian randomisation study and meta-analysis. Diabetologia. 2021. doi: 10.1007/s00125-021-05436-0. Online ahead of print.
  • Fuller JH, Shipley MJ, Rose G, et al. Mortality from coronary heart disease and stroke in relation to degree of glycemia: the Whitehall study. BMJ. 1983; 287: 867-868.
  • Oizumi T, Daimon M, Jimbu Y, et al. Impaired glucose tolerance is a risk factor for stroke in a Japanese sample–the Funagata study. Metabolism. 2008; 57: 333-338.
  • Qureshi AI, Giles WH, Croft JB. Impaired glucose tolerance and the likelihood of nonfatal stroke and myocardial infarction: the Third National Health and Nutrition Examination Survey. Stroke. 1998; 29: 1329-1332.
  • Kuller LH, Velentgas P, Barzilay J, et al. Diabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality. Arterioscler Thromb Vasc Biol. 2000; 20: 823-829.
  1. Cai X, Zhang Y, Li M, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370:m2297. doi:10.1136/bmj.m2297.
  • Kuusisto J, Mykkanen L, Pyorala K, Laakso M. Non-insulin-dependent diabetes and its metabolic control are important predictors of stroke in elderly patients. Stroke. 1994; 25: 1157-1164.
  • Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Predictors of stroke in middle-aged patients with non–insulin-dependent diabetes. Stroke 1996; 27: 63-68.
  • De Marco R, Locatelli F, Zoppini G, et al. Cause-specific mortality in type 2 diabetes. The Verona Diabetes Study. Diabetes Care. 1999; 22: 756-761.
  • Jeerakathil T, Johnson JA, Simpson SH, Majumdar SR Short-term risk for stroke is doubled in persons with newly treated type 2 diabetes compared with persons without diabetes: a population-based cohort study. Stroke. 2007; 38: 1739-1743.
  • Klein R, Sharrett AR, Klein BE et al. The association of atherosclerosis, vascular risk factors, and retinopathy in adults with diabetes: the atherosclerosis risk in communities study. Ophthalmology. 2002; 109: 1225-1234.
  • Wong KH, Hu K, Peterson C, et al. Diabetic Retinopathy and Risk of Stroke: A Secondary Analysis of the ACCORD Eye Study. Stroke. 2020;51(12):3733-3736.
  • Miettinen H, Haffner SM, Lehto S, et al. Proteinuria predicts stroke and other atherosclerotic vascular disease events in nondiabetic and non-insulin-dependent diabetic subjects. Stroke. 1996; 27: 2033-2039.
  • Hägg S, Thorn LM, Putaala J, et al. Incidence of stroke according to presence of diabetic nephropathy and severe diabetic retinopathy in patients with type 1 diabetes. Diabetes Care. 2013; 36(12):4140-4146.
  • Cohen JA, Estacio RO, Lundgren RA, et al. Diabetic autonomic neuropathy is associated with an increased incidence of strokes. Auton Neurosci. 2003; 108: 73-78.
  • Toyry JP, Niskanen LK, Lansimies EA, et al. Autonomic neuropathy predicts the development of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1996; 27: 1316-1318.
  • Ninomiya JK, L’Italien G, Criqui MH, et al. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation. 2004; 109: 42-46.
  • Kurl S, Laukkanen JA, Niskanen L, et al. Metabolic syndrome and the risk of stroke in middle-aged men. Stroke. 2006; 37: 806-811.
  • Qiao Q, Laatikainen T, Zethelius B, et al. Comparison of definitions of metabolic syndrome in relation to the risk of developing stroke and coronary heart disease in finnish and Swedish cohorts. Stroke. 2009; 40: 337-343.
  • Najarian RM, Sullivan LM, Kannel WB, et al. Metabolic syndrome compared with type 2 diabetes mellitus as a risk factor for stroke: the Framingham Offspring Study. Arch Intern Med. 2006; 166: 106-111.
  • Koren-Morag N, Goldbourt U, Tanne D. Relation between the metabolic syndrome and ischemic stroke or transient ischemic attack: a prospective cohort study in patients with atherosclerotic cardiovascular disease. Stroke. 2005; 36: 1366-1371.
  • De Boer MD, Filipp SL, Sims M, et al. Risk of Ischemic Stroke Increases Over the Spectrum of Metabolic Syndrome Severity. Stroke. 2020;51(8): 2548-2552.
  1. Adler AI, Levy JC, Matthews DR, et al. Insulin sensitivity at diagnosis of Type 2 diabetes is not associated with subsequent cardiovascular disease (UKPDS 67). Diabet Med. 2005; 22: 306-311.
  • Pyorala M, Miettinen H, Laakso M, Pyorala K. Plasma insulin and all-cause, cardiovascular and noncardiovascular mortality. The 22-year follow-up results of the Helsinki Policemen Study. Diabetes Care. 2000; 23: 1097-1102.
  • Lakka HM, Lakka TA, Tuomilehto J, et al. Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Arch Intern Med. 2000; 160: 1160-1168.
  • Harshfield EL, Pennells L, Schwartz JE, et al. Association Between Depressive Symptoms and Incident Cardiovascular Diseases. JAMA. 2020;324(23): 2396-2405.