脂肪蛋白和心血管疾病
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
概括
高脂蛋白增加心血管疾病的风险. 脂蛋白的终身测量可以指导高风险个体的生活方式和药物使用,有希望的新药正在开发中.
科学领域:
- 心脏病学
- 遗传学
- 流行病学
背景情况:
- 高脂蛋白 (a) 影响五分之一的人,增加动脉样性心血管疾病和大动脉狭窄的风险.
- 脂蛋白水平表现出显著的种族和性别差异,其度是基因决定的.
- 由于缺乏针对脂蛋白的批准疗法,目前的管理重点是生活方式和其他风险因素的降低.
研究的目的:
- 在心血管疾病中提供脂蛋白的综合性审查.
- 讨论脂蛋白的遗传,流行病学和临床方面.
- 探索目前和未来降低脂蛋白的治疗策略.
主要方法:
- 对历史观点,生理学,病理生理学和遗传证据的审查.
- 对不同人群中脂蛋白度的流行病学数据的分析.
- 检查脂蛋白在家族高胆固醇和糖尿病中的作用.
- 评估目前的管理,查,诊断和预防策略.
- 临床试验中的新兴脂蛋白降低药物的评估.
主要成果:
- 在东亚/东南亚和欧洲人中脂蛋白度最低,在南亚/中东/拉丁美洲人中中等,在非洲人中最高.
- 在绝经后的女性中,基因决定度超过90%,比男性高17%.
- 许多正在研发的药物显示其可显著降低65-98%的脂蛋白.
结论:
- 对于高心血管风险的个人,建议对脂蛋白进行终身查.
- 早期检测和风险因素管理对于脂肪蛋白升高的个体至关重要.
- 新兴疗法有望直接降低脂蛋白和减轻心血管风险.
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