传统和新型标记物:治疗目标与风险标记物
G B John Mancini1, Paul Poirier2, Daniel Esau3
1Division of Cardiology, Centre for Cardiovascular Innovation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
The Canadian journal of cardiology
|August 7, 2024
概括
低密度脂蛋白胆固醇 (LDL-C) 单独可能无法充分评估心血管风险. 测量甘油三 (TGs) 和脂蛋白[Lp]提供了更全面的心血管风险评估.
科学领域:
- 心血管医学 心血管医学
- 脂质学 脂质学是指脂质学.
- 预防性心脏病学 预防性心脏病学
背景情况:
- 低密度脂蛋白胆固醇 (LDL-C) 是心血管 (CV) 风险的主要标志物,与动脉样硬化疾病直接相关.
- 传统的心血管风险评估通常依赖于LDL-C,通常通过弗里德瓦尔德方程估计,这可能无法捕捉完整的风险概况.
- 新出现的证据突出显示,除了LDL-C之外,其他脂质标记物的重要性.
研究的目的:
- 讨论与心血管风险相关的脂质相关标志物.
- 强调非高密度脂蛋白胆固醇和阿波蛋白B100与LDL-C一起的重要性.
- 强调需要将甘油三和脂蛋白纳入全面的心血管风险评估.
主要方法:
- 审查和讨论当前关于脂质标记物和心血管风险的文献.
- 使用弗里德瓦尔德方程,分析LDL-C估计的局限性.
- 检查甘油三 (TGs) 和脂蛋白在心血管疾病中的作用.
主要成果:
- 升高的TG可能表明非LDL颗粒中的胆固醇增加,这表明非高密度脂蛋白胆固醇或无脂蛋白B100是更准确的风险指标.
- 脂蛋白 (Lp) 是一种由基因决定的类似于LDL的粒子,具有炎症和前血栓性质,有助于心血管风险.
- 针对Lp(a) 的新疗法正在出现,但它们在预防心血管结局方面的临床益处需要进一步验证.
结论:
- 虽然LDL-C仍然很重要,但它的局限性需要更广泛的评估.
- 三甘油 (TG) 和脂蛋白 (Lp) 是为更准确和更全面的心血管风险评估提供关键的新兴标记物.
- 医疗保健专业人员应该重新评估传统的脂质评估策略,以包括TG和Lp.
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