Impact of Remnant Cholesterol on Cardiovascular Risk in Diabetes.

IF 5.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Current Diabetes Reports Pub Date : 2024-12-01 Epub Date: 2024-10-02 DOI:10.1007/s11892-024-01555-1

Daniel Elías-López, Benjamin Nilsson Wadström, Signe Vedel-Krogh, Camilla Jannie Kobylecki, Børge Grønne Nordestgaard

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Abstract

Purpose of review: Individuals with diabetes face increased risk of atherosclerotic cardiovascular disease (ASCVD), in part due to hyperlipidemia. Even after LDL cholesterol-lowering, residual ASCVD risk persists, part of which may be attributed to elevated remnant cholesterol. We describe the impact of elevated remnant cholesterol on ASCVD risk in diabetes.

Recent findings: Preclinical, observational, and Mendelian randomization studies robustly suggest that elevated remnant cholesterol causally increases risk of ASCVD, suggesting remnant cholesterol could be a treatment target. However, the results of recent clinical trials of omega-3 fatty acids and fibrates, which lower levels of remnant cholesterol in individuals with diabetes, are conflicting in terms of ASCVD prevention. This is likely partly due to neutral effects of these drugs on the total level of apolipoprotein B(apoB)-containing lipoproteins. Elevated remnant cholesterol remains a likely cause of ASCVD in diabetes. Remnant cholesterol-lowering therapies should also lower apoB levels to reduce risk of ASCVD.

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残余胆固醇对糖尿病患者心血管风险的影响

综述的目的：糖尿病患者罹患动脉粥样硬化性心血管疾病（ASCVD）的风险增加，部分原因在于高脂血症。即使在降低低密度脂蛋白胆固醇后，残余的 ASCVD 风险依然存在，其中部分原因可能是残余胆固醇升高。我们描述了残余胆固醇升高对糖尿病患者 ASCVD 风险的影响：临床前研究、观察性研究和孟德尔随机研究均有力地表明，残余胆固醇升高会增加 ASCVD 风险，这表明残余胆固醇可作为治疗目标。然而，最近关于降低糖尿病患者残余胆固醇水平的欧米伽-3 脂肪酸和纤维酸盐的临床试验结果在预防 ASCVD 方面却相互矛盾。部分原因可能是这些药物对含载脂蛋白 B（apoB）脂蛋白总水平的影响是中性的。残余胆固醇升高仍可能是糖尿病患者发生 ASCVD 的原因之一。降低残余胆固醇的疗法也应降低载脂蛋白B的水平，以降低ASCVD的风险。

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来源期刊

Current Diabetes Reports 医学 -

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The goal of this journal is to publish cutting-edge reviews on subjects pertinent to all aspects of diabetes epidemiology, pathophysiology, and management. We aim to provide incisive, insightful, and balanced contributions from leading experts in each relevant domain that will be of immediate interest to a wide readership of clinicians, basic scientists, and translational investigators. We accomplish this aim by appointing major authorities to serve as Section Editors in key subject areas across the discipline. Section Editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year on their topics, in a crisp and readable format. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.