脂質タンパク質と心血管疾患
Børge G Nordestgaard1, Anne Langsted1
1Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Lancet (London, England)
|September 15, 2024
まとめ
脂質たんぱく質の高さは 心血管疾患のリスクを高めます 脂質タンパク質の生涯測定は,高いリスクのある個人のライフスタイルと薬剤を導き,有望な新薬を開発することができます.
科学分野:
- 心臓病科
- 遺伝学
- エピデミオロジー
背景:
- 高脂質 (a) は5人に1人に影響し,動脈硬化性心血管疾患と大動脈弁の狭窄のリスクを高めます.
- リポプロテイン (a) レベルは,遺伝学的に決定される濃度で,民族および性に基づく有意な変動を示します.
- 現在の管理は,リポプロテインを標的とした承認された治療法がないため,ライフスタイルやその他のリスク要因の減少に焦点を当てています.
研究 の 目的:
- 心血管疾患におけるリポプロテイン (a) の包括的な見直しを提供すること.
- 脂質タンパク質の遺伝的,疫学的,および臨床的側面について議論する.
- 脂質タンパク質を低下させるための現在のおよび将来の治療戦略を探求する.
主な方法:
- 歴史的視点,生理学,病理学,遺伝的証拠のレビュー
- 多様な集団における脂質タンパク質の濃度に関する流行病学的データの分析
- 家族性高コレステロール血症と糖尿病における脂質タンパク質の役割の検討
- 現在の管理,スクリーニング,診断,予防戦略の評価
- 臨床試験における新興の脂質タンパク質を低下させる薬の評価
主要な成果:
- 脂質タンパク質 (a) の濃度は東アジア人,東南アジア人,ヨーロッパ人に最も低く,南アジア人,中東人,ラテンアメリカ人に最も高く,アフリカ人に最も高い.
- 濃度は90%以上遺伝的に決定され,更年期後の女性では男性より17%高い.
- 開発中の多くの薬剤は,リポプロテインを65~98%大幅に低下させる可能性を示しています.
結論:
- 心血管疾患のリスクが高い個体には,生涯にわたる脂質タンパク質のスクリーニングが推奨されます.
- 早期発見とリスクファクターの管理は,リポプロテイン値が上昇した個体にとって極めて重要です.
- 新興治療法は,リポプロテインを直接減少させ,心血管疾患のリスクを軽減するために有望である.
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