《国际循环》：您对于2型糖尿病患者降脂治疗对心血管事件的影响有什么看法？
 

    Henry Ginsberg：对于2型糖尿病患者，他汀是一类很不错的治疗药物。他汀类药物能够降低糖尿病患者的心血管风险，其降低幅度与非糖尿病患者相近。此外，他汀的作用很强，其疗效非常不错，安全性也非常好。但是，在应用他汀类药物治疗后，糖尿病患者还是残留很高的心血管风险。ACCORD血脂试验设计的理念就是针对LDL-C升高以外的其他血脂异常，包括低HDL-C和高TG。针对此种血脂异常，我们可以选择烟酸，效果也很不错。我们也可以选择非诺贝特。最终，ACCORD血脂试验将非诺贝特作为试验药物，因为烟酸会影响到血糖水平。就ACCORD血脂试验来讲，我们希望达到非常严格的血糖控制，因此应用烟酸并不理想。

   <International Circulation>: What is your opinion on the role of lipid therapy on cardiovascular events in type 2 Diabetes?

   Dr Henry Ginsberg: Statin therapy is terrific for type 2 diabetics， it lowers their events in a relative sense as much as compared to non diabetics. It is also robust， the efficacy is terrific， the safety is excellent but they are often left with still high event rates. The idea of the ACCORD lipid trial was to attack the other abnormalities the low HDL and the high blood triglycerides. We had two choices， Niacin which does that very well and we had fenofibrate. We choose fenofibrate because   affects blood glucose levels and so in the context of the ACCORD trial were we attempted to get very tight glucose control， niacin was not a good drug to use. 
 

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