高密度脂質タンパク質を治療目標として: 体系的なレビュー
Inder M Singh1, Mehdi H Shishehbor, Benjamin J Ansell
1Department of Cardiovascular Medicine, Krannert Institute of Cardiology, Indiana University Medical Center, Indianapolis, USA. shishem@gmail.com
JAMA
|August 21, 2007
まとめ
現在の戦略では,高密度の脂質タンパク質コレステロール (HDL-C) を20〜30%上昇させることができますが,他の脂質から独立して心血管上の利点の証拠は限られています. 心血管疾患の予防のためにHDL-Cの改変を調査するためにさらなる試験が必要である.
科学分野:
- 心血管医学は,心臓血管医学である.
- 脂質代謝についてです.
- 薬理学 薬理学とは
背景:
- 高密度リポプロテインコレステロール (HDL-C) は,心臓血管疾患の重要なリスク因子であり,治療対象として増加しています.
- HDL-C代謝の理解は,効果的な心血管疾患 (CVD) 予防戦略の開発に不可欠です.
研究 の 目的:
- 高密度リポタンパク質 (HDL) を改変するための現行および新興戦略をレビューする.
- 心血管疾患のアウトカムに対するHDL-C変化を支持する証拠を評価する.
主な方法:
- MEDLINEとコクランデータベースでの体系的な文献検索 (1965年 - 2007年5月).
- 優先的にランダム化比較試験,メタ解析,メカニズム研究を行いました.
- 主要な心血管会議のプレゼンテーションと進行中の臨床試験のレビューが含まれています.
主要な成果:
- 31件のランダム化対照試験は,含有基準を満たした.
- 最適化された現在の戦略は,HDL-Cを20〜30%増加させます.
- LDL-Cまたはトリグリセリドから独立して心血管結果の減少の証拠は難解である;新薬はHDL-Cに変動する効果を示している.
結論:
- 控えめな証拠は,ライフスタイルの変更を超えて,積極的なHDL-C上昇を支持しています.
- HDL代謝経路を標的とした現在進行中の試験は,新しい心臓血管治療の選択肢を提供することがあります.
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