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降低糖尿病中的脂质:最新情况

Alan Chait1, Robert H Eckel2, Michal Vrablik3

  • 1Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, WA, USA.

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糖尿病患者经历了加速动脉样性心血管疾病 (ASCVD). 组合疗法,如他类药物加以西西米布,被推用于管理失脂症和预防ASCVD事件.

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科学领域:

  • 心脏病学 心脏病学
  • 内分泌学 在内分泌学.
  • 药理学 药理学是指药理学的学科.

背景情况:

  • 糖尿病加速动脉样硬化心血管疾病 (ASCVD) 通过诸如失脂症,高血糖症,氧化应激和炎症等机制.
  • 1型糖尿病具有独特的因素,有助于加速动脉样硬化.
  • 有临床指导方针用于查,风险评估和糖尿病患者ASCVD的治疗.

研究的目的:

  • 审查目前在糖尿病患者中预防ASCVD的战略.
  • 讨论脂质管理在减轻ASCVD风险中的作用.
  • 评估各种治疗干预措施的有效性和理由.

主要方法:

  • 审查现有的临床指导方针和治疗方法,以预防ASCVD糖尿病.
  • 对他类药物治疗的益处和对补充治疗的需要的分析.
  • 评估针对脂蛋白代谢的新兴疗法.

主要成果:

  • 类固醇药物治疗显著减少糖尿病患者心血管疾病 (CVD) 的发生.
  • 许多患者需要额外的治疗方法 (ezetimibe,bempedoic acid,PCSK9抑制剂) 来实现推的低密度脂蛋白 (LDL) 目标.
  • 组合疗法,特别是他类药物加以替,是一种合理的初始治疗策略.
  • 伊可萨乙烯显示有好处,可能是通过非甘油三降低机制.
  • 像ApoC-III和ANGPTL3抑制剂这样的新药显示出进一步降低脂蛋白的前景.

结论:

  • 积极的脂质管理对于预防糖尿病中ASCVD至关重要.
  • 为了达到LDL目标,通常需要组合疗法.
  • 新兴的治疗方法在未来有可能在这个人群中提高ASCVD风险降低.