冠状病毒病和血脂异常——有联系吗?

V. Akhmedov
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引用次数: 0

摘要

血脂异常是感染SARS-CoV-2冠状病毒患者最常见的合并症之一。在本文中,作者基于最新的文献综述,评估了血脂异常对COVID-19感染患者临床病程和预后的潜在影响,以及病毒感染对血脂异常患者血脂谱的影响。新冠肺炎引发的炎症反应导致高密度脂蛋白(HDL)水平升高,载脂蛋白调节,血清淀粉样蛋白A浓度升高,载脂蛋白A- i、M和E水平降低,从而影响HDL的抗氧化、抗炎和免疫调节特性。在COVID-19患者中使用他汀类药物可降低脂质紊乱的风险。通过抑制内源性胆固醇合成,他汀类药物可减少其在脂筏中的数量,从而可能限制SARS-CoV-2病毒进入宿主细胞。此外,他汀类药物通过减少促炎细胞因子的过度表达,可以对抗covid -19相关的细胞因子风暴。关键词:COVID-19、血脂异常、肥胖、治疗、脂蛋白、他汀类药物、贝特类药物引用本文:Akhmedov V.A.冠状病毒病和血脂异常——有联系吗?俄罗斯医学调查。2023;7(1):36 - 40(俄文)。DOI: 10.32364 / 2587-6821-2023-7-1-36-40。
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Coronavirus disease and dyslipidemia — is there an association?
Dyslipidemia is one of the most common comorbidities in patients infected with the SARS-CoV-2 coronavirus. In this review based on the up- to-date publications the authors assess the potential impact of dyslipidemia on the clinical course and prognosis in COVID-19 infected patients, as well as the viral infection effects on the lipid profile in patients with dyslipidemia. The COVID-19 driven inflammatory response leads to an increase in high-density lipoprotein (HDL) levels, modulation of apolipoproteins, increase in serum amyloid protein A concentration, and a decrease in apolipoprotein A-I, M and E levels, thus affecting the antioxidant, anti-inflammatory and immunomodulatory properties of HDL. The use of statins in patients with COVID-19 may mitigate the risk of lipid disorders. By inhibiting endogenous cholesterol synthesis, statins reduce its amount in lipid rafts and therefore may limit the entry of the SARS-CoV-2 virus into host cells. Moreover, statins, by reducing the overexpression of proinflammatory cytokines, can counteract COVID-19-associated cytokine storm. KEYWORDS: COVID-19, dyslipidemia, obesity, treatment, lipoproteins, statins, fibrates. FOR CITATION: Akhmedov V.A. Coronavirus disease and dyslipidemia — is there an association? Russian Medical Inquiry. 2023;7(1):36– 40 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-36-40.
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