Contemporary Diagnosis and Management of Type 2 Diabetes [antikvár]

Chapter 1 Pathophysiology of Type 2 Diabetes A Quartet of Abnormalities Type 2 diabetes and the hyperglycemia and hyper-insulinemia that characterize it are estabUshed risk factors for cardiovascular disease.' Obesity, dyslipidemia, and hypertension are also risk factors for cardiovascular disease and are associated with type 2 diabetes.^ Kaplan considered obesity, particularly the upper-body, central, or android type, to be the key risk factor for cardiovascular disease and argued that it could account for the other cofactors by promoting dyslipidemia and peripheral insulin resistance. Because of its contribution to mortality related to atherosclerotic heart disease, Kaplan termed the risk-factor cluster of diabetes, obesity, hypertriglyceridemia, and hypertension 'the deadly quartet.'^ The appropriateness of this term was documented by a follow-up study of patients who received an isolated coronary artery bypass graft, in whom the presence of the deadly quartet was associated with a mortality hazard ratio of 2.5 for men and 13.4 for women.'^ This quartet of risk factors has been referred to by a variety of names, including syndrome X,^ the cardiovascular metabolic syndrome, the dysmetabolic syndrome,^ and the