2 型糖尿病患者血脂异常治疗的重要性--叙述性综述

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM Diabetology Pub Date : 2023-12-04 DOI:10.3390/diabetology4040048
Dominik Strikić, Andro Vujević, D. Perica, D. Leskovar, Kristina Paponja, I. Pećin, I. Merćep
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引用次数: 0

摘要

2型糖尿病(T2DM)是一种以胰岛素抵抗和血糖水平升高为特征的常见代谢性疾病,影响着全世界数百万人。伴有血脂异常的2型糖尿病患者发生心血管疾病(CVD)的风险增加。高血糖、血脂异常、高血压、肥胖、炎症和氧化应激等危险因素的复杂相互作用有利于动脉粥样硬化的发展,这是心血管疾病发病机制的核心机制。血脂异常是T2DM的一个标志,其特征是甘油三酯升高,高密度脂蛋白(HDL)胆固醇降低,存在小而致密的低密度脂蛋白(LDL)颗粒,所有这些都促进动脉粥样硬化。在这篇文章中,我们试图提出各种治疗策略,包括药物干预,如他汀类药物、依折替米贝、PCSK9抑制剂、贝特类药物和omega-3脂肪酸。我们还试图强调生活方式的改变,包括身体活动和饮食的改变,在改善2型糖尿病患者的血脂和整体心血管健康方面的关键作用。我们也试图提出最新的2型糖尿病患者血脂异常管理的临床指南。总之,治疗2型糖尿病患者的血脂异常非常重要,因为它可以降低脂质颗粒水平,减缓动脉粥样硬化的进展,最终降低心血管疾病的易感性。
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Importance of Dyslipidaemia Treatment in Individuals with Type 2 Diabetes Mellitus—A Narrative Review
Type 2 diabetes mellitus (T2DM) is a common metabolic disease characterised by insulin resistance and elevated blood glucose levels, affecting millions of people worldwide. T2DM individuals with dyslipidaemia have an increased risk of cardiovascular disease (CVD). A complex interplay of risk factors such as hyperglycaemia, dyslipidaemia, hypertension, obesity, inflammation, and oxidative stress favour the development of atherosclerosis, a central mechanism in the pathogenesis of cardiovascular disease. Dyslipidaemia, a hallmark of T2DM, is characterised by elevated triglycerides, decreased high-density lipoprotein (HDL) cholesterol and the presence of small, dense low-density lipoprotein (LDL) particles, all of which promote atherosclerosis. In this article, we have attempted to present various treatment strategies that include pharmacological interventions such as statins, ezetimibe, PCSK9 inhibitors, fibrates, and omega-3 fatty acids. We have also tried to highlight the pivotal role of lifestyle modifications, including physical activity and dietary changes, in improving lipid profiles and overall cardiovascular health in T2DM individuals. We have also tried to present the latest clinical guidelines for the management of dyslipidaemia in T2DM individuals. In conclusion, the treatment of dyslipidaemia in T2DM individuals is of great importance as it lowers lipid particle levels, slows the progression of atherosclerosis, and ultimately reduces susceptibility to cardiovascular disease.
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