cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1262Research ArticleМНЕНИЕ ПО ПРОБЛЕМЕПостпрандиальная гипергликемия и сердечно- сосудистые осложнения. Применение акарбозы у больных коронарной болезнью сердца с нарушенным углеводным обменомPostprandial hyperglycemia and cardiovascular events. Acarbose therapy in patients with coronary heart disease and impaired carbohydrate metabolismЛогуноваН. А.LogunovaN. A.nlogunova@bk.ruБубноваМ. Г.BubnovaM. G.nlogunova@bk.ruПероваН. В.PerovaN. V.nlogunova@bk.ruГосударственный научно-исследовательский центр профилактической медицины Росмедтехнологии. МоскваState Research Center for Preventive Medicine, Federal Agency on High Medical Technologies. Moscow200820102008759199Copyright © Логунова Н.А., Бубнова М.Г., Перова Н.В., 20082008Логунова Н.А., Бубнова М.Г., Перова Н.В.Logunova N.A., Bubnova M.G., Perova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1262

Статья посвящена роли постпрандиальной гипергликемии в развитии сердечно-сосудистых осложнений (ССО). Изложены современные представления о механизмах развития постпрандиальной гипергликемии, ее влиянии на прогрессирование сахарного диабета типа 2 и ССО. Рассмотрен вопрос контроля постпрандиальной гипергликемии с помощью ингибитора альфа-глюкозидазы – акарбозы, и приведены результаты исследования влияния этого препарата на показатели физической работоспособности и метаболические факторы атерогенеза у больных коронарной болезнью сердца с нарушенным углеводным обменом.

The article is focused on postprandial hyperglycemia role in cardiovascular event (CVE) development. Modern views on postprandial hyperglycemia pathogenetic mechanisms, its effects on type 2 diabetes mellitus progression and CVE are presented. Postprandial hyperglycemia control with an alpha-glucosidase inhibitor acarbose is discussed, and data are presented on acarbose influence on physical fitness and atherogenic metabolic factors in patients with coronary heart disease and impaired carbohydrate metabolism.

постпрандиальная гипергликемиясахарный диабет типа 2коронарная болезнь сердцаакарбозаPostprandial hyperglycemiaType 2 diabetes mellituscoronary heartReferencesAlberti K, Zimmet P. Definition, diagnosis and classification of diabetes mellitus and its complications. Provisional report of a WHO consultation. Diabet Med 1998; 15(7): 539–53.Alberti K, Zimmet P. Definition, diagnosis and classification of diabetes mellitus and its complications. Provisional report of a WHO consultation. Diabet Med 1998; 15(7): 539–53.Дедов И.И., Шестакова М.В. Сахарный диабет и артериальная гипертензия. Москва, изд-во “МИА” 2006; 320–9.Дедов И.И., Шестакова М.В. Сахарный диабет и артериальная гипертензия. Москва, изд-во “МИА” 2006; 320–9.Expert Committee of the Diagnosis and Classification of diabetes mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26: 3160–7.Expert Committee of the Diagnosis and Classification of diabetes mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26: 3160–7.Unwin N, Shaw J, Zimmet P, Alberti G. Impaired glucose tolerance and impaired fasting glycaemia: the current status of definition and intervention. Diabet Med 2002; 19:1–17.Unwin N, Shaw J, Zimmet P, Alberti G. Impaired glucose tolerance and impaired fasting glycaemia: the current status of definition and intervention. Diabet Med 2002; 19:1–17.Zimmet P, Alberti K, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001; 414: 782–7.Zimmet P, Alberti K, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001; 414: 782–7.Ceriello A, Quagliaro L, Piconi L, et al. Effect of postprandial hypertriglyceridemia and hyperglycemia on circulating adhesion molecules and oxidative stress generation and the possible role of simvastatin treatment. Diabetes 2004; 53: 701–10.Ceriello A, Quagliaro L, Piconi L, et al. Effect of postprandial hypertriglyceridemia and hyperglycemia on circulating adhesion molecules and oxidative stress generation and the possible role of simvastatin treatment. Diabetes 2004; 53: 701–10.Hanefeld M, Temelkova-Kurktschiev T. The postprandial state and the risk of atherosclerosis. Diabet Med 1997; 14(Suppl 3): S6–11.Hanefeld M, Temelkova-Kurktschiev T. The postprandial state and the risk of atherosclerosis. Diabet Med 1997; 14(Suppl 3): S6–11.Yamagishi SI, Nakamura K, Matsui T, et al. Role of postprandial hyperglycemia in cardiovascular disease in diabetes. Int J Clin Pract 2007; 61(1): 83–7.Yamagishi SI, Nakamura K, Matsui T, et al. Role of postprandial hyperglycemia in cardiovascular disease in diabetes. Int J Clin Pract 2007; 61(1): 83–7.American Diabetes Association. Diagnosis and Classification of diabetes mellitus. Diabetes Care 2004; 27(Suppl. I): S5–10.American Diabetes Association. Diagnosis and Classification of diabetes mellitus. Diabetes Care 2004; 27(Suppl. I): S5–10.Members TF, Ryden L, Standl E, et al. Guidelines on diabetes, prediabetes, and cardiovascular diseases: executive summary. Eur Heart J 2007; 28: 88–136.Members TF, Ryden L, Standl E, et al. Guidelines on diabetes, prediabetes, and cardiovascular diseases: executive summary. Eur Heart J 2007; 28: 88–136.Owens DR, Luzio SD, Coates PA. Postprandial level of glycose: the key factor of risk for diabetes mellitus type 2. Diabet Med 1996;13(Suppl 6): S19–24.Owens DR, Luzio SD, Coates PA. Postprandial level of glycose: the key factor of risk for diabetes mellitus type 2. Diabet Med 1996;13(Suppl 6): S19–24.Polonsky K, Given B, Hirch L, et al. Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus. New Eng J Med 1998; 318: 1231–9.Polonsky K, Given B, Hirch L, et al. Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus. New Eng J Med 1998; 318: 1231–9.Matthaei S, Stumvoll M, Kellerer M, et al. Pathophysiology and Pharmacological Treatment of Insulin Resistance. Endocr Rev 2000; 21(6): 585–618.Matthaei S, Stumvoll M, Kellerer M, et al. Pathophysiology and Pharmacological Treatment of Insulin Resistance. Endocr Rev 2000; 21(6): 585–618.Alipour A, Elte JW, van Zaanen HC, et al. Postprandial inflammation and endothelial dysfunction. Review Biochem Soc Trans 2007; 35(Pt3): 466–9.Alipour A, Elte JW, van Zaanen HC, et al. Postprandial inflammation and endothelial dysfunction. Review Biochem Soc Trans 2007; 35(Pt3): 466–9.Palmer RM, Ferrige AG, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987; 327: 524–6.Palmer RM, Ferrige AG, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987; 327: 524–6.Tiritilli A. Nitric oxide (NO), vascular protection factor. Biology, physiological role and biochemistry of NO. Press Med 1998; 27(21):1061–4.Tiritilli A. Nitric oxide (NO), vascular protection factor. Biology, physiological role and biochemistry of NO. Press Med 1998; 27(21):1061–4.Кondo K, Taguchi C, Kishimoto Y. Postprandial hyperlipidaemia. Nippon Rinsho 2007; 65(Suppl 7): 375–8.Кondo K, Taguchi C, Kishimoto Y. Postprandial hyperlipidaemia. Nippon Rinsho 2007; 65(Suppl 7): 375–8.Haffner SM. Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes. Eur Heart J 2006; 8(Suppl B): B20–5.Haffner SM. Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes. Eur Heart J 2006; 8(Suppl B): B20–5.Nitenberg A, Cosson E, Phan I. Postprandial endothelial dysfunction: role of glucose, lipids and insulin. Diabet Metab 2006; 32(Spec 2): 2S 28–33.Nitenberg A, Cosson E, Phan I. Postprandial endothelial dysfunction: role of glucose, lipids and insulin. Diabet Metab 2006; 32(Spec 2): 2S 28–33.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.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.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(2): 163–9.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(2): 163–9.Hanefeld M, Fischer S, Julius U, et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia 1996; 39(12): 1577–83.Hanefeld M, Fischer S, Julius U, et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia 1996; 39(12): 1577–83.Rodriguez BL, Lau N, Burchfiel CM, et al. Glucose intolerance and 23-year risk of coronary heart disease and total mortality: the Honolulu Heart Program. Diabetes Care 1998; 22(8): 1262–5.Rodriguez BL, Lau N, Burchfiel CM, et al. Glucose intolerance and 23-year risk of coronary heart disease and total mortality: the Honolulu Heart Program. Diabetes Care 1998; 22(8): 1262–5.Balkau B, Forhan DM, Eschwege E. Two hour plasma glucose is not unequivocally predictive for early death in men with impaired fasting glucose: more results from the Paris Prospective Study. Diabetologia 2002; 45(9): 1224–30.Balkau B, Forhan DM, Eschwege E. Two hour plasma glucose is not unequivocally predictive for early death in men with impaired fasting glucose: more results from the Paris Prospective Study. Diabetologia 2002; 45(9): 1224–30.Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men: the Rancho Bernardo Study. Diabetes Care 1998; 21(8): 1236–9.Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men: the Rancho Bernardo Study. Diabetes Care 1998; 21(8): 1236–9.De Vegt F, Dekker JM, Ruhe HG, et al. Hyperglycemia is associated with all-cause an cardiovascular mortality in the Hoorn population: the Hoorn study. Diabetologia 1999; 42(8): 926–31.De Vegt F, Dekker JM, Ruhe HG, et al. Hyperglycemia is associated with all-cause an cardiovascular mortality in the Hoorn population: the Hoorn study. Diabetologia 1999; 42(8): 926–31.Lebovitz H. Alpha-glucosidase inhibitors. Endocrinol Metab Clin North Am 1997; 26: 539–51.Lebovitz H. Alpha-glucosidase inhibitors. Endocrinol Metab Clin North Am 1997; 26: 539–51.Мкртумян АМ, Давыдов АЛ, Подачина СВ, Щукина ВН. Влияние постпрандиальной гликемии на сердечно-сосудистую заболеваемость больных сахарным диабетом 2 типа и её коррекция. Cons Med 2004; 06(9): 25–32.Мкртумян АМ, Давыдов АЛ, Подачина СВ, Щукина ВН. Влияние постпрандиальной гликемии на сердечно-сосудистую заболеваемость больных сахарным диабетом 2 типа и её коррекция. Cons Med 2004; 06(9): 25–32.Breuer H-W. Review of acarbose therapeutic strategies in the long-term treatment and in the prevention of type 2 diabetes. Int J Clin Pharmacol Ther 2003; 41: 421–40.Breuer H-W. Review of acarbose therapeutic strategies in the long-term treatment and in the prevention of type 2 diabetes. Int J Clin Pharmacol Ther 2003; 41: 421–40.Chiasson J, Josse R, Gomis R, et al. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomized trial. Lancet 2002; 359(9323): 2072–7.Chiasson J, Josse R, Gomis R, et al. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomized trial. Lancet 2002; 359(9323): 2072–7.Hanefeld M, Chiasson J, Koehler C, et al. Acarbose slows progression of intima-media thickness of the carotid arteries in subjects with impaired glucose tolerance. Stroke 2004; 35: 1073–8.Hanefeld M, Chiasson J, Koehler C, et al. Acarbose slows progression of intima-media thickness of the carotid arteries in subjects with impaired glucose tolerance. Stroke 2004; 35: 1073–8.Hanefeld M, Cagatay M, Petrowisch T, et al. Acarbose redused the risk of myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies. Eur Heart J 2004; 25: 10–6.Hanefeld M, Cagatay M, Petrowisch T, et al. Acarbose redused the risk of myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies. Eur Heart J 2004; 25: 10–6.Аронов Д.М., Бубнова М.Г. Разнообразие механизмов действия акарбозы и ее роль в профилактике сахарного диабета 2 типа и сердечно-сосудистых заболеваний. Клин фармак тер 2004; 13(4); 26–30.Аронов Д.М., Бубнова М.Г. Разнообразие механизмов действия акарбозы и ее роль в профилактике сахарного диабета 2 типа и сердечно-сосудистых заболеваний. Клин фармак тер 2004; 13(4); 26–30.Бубнова М.Г., Перова Н.В., Логунова Н.А., Потапова В.В. Влияние комбинированной углеводной и физической нагрузок на метаболические показатели у лиц без КБС и больных КБС. Тезисы VI Российской научной конференции “Реабилитация и вторичная профилактика в кардиологии” 2005; 5: 122–3.Бубнова М.Г., Перова Н.В., Логунова Н.А., Потапова В.В. Влияние комбинированной углеводной и физической нагрузок на метаболические показатели у лиц без КБС и больных КБС. Тезисы VI Российской научной конференции “Реабилитация и вторичная профилактика в кардиологии” 2005; 5: 122–3.Baliga RR, Burden L, Sidhu MK. Effects of components of meals (carbohydrate, fat, protein) in causing postprandial exertional angina pectoris. Am J Cardiol 1997; 79910: 1397–400.Baliga RR, Burden L, Sidhu MK. Effects of components of meals (carbohydrate, fat, protein) in causing postprandial exertional angina pectoris. Am J Cardiol 1997; 79910: 1397–400.

The authors declare that there are no conflicts of interest present.