内分泌失调对血脂和脂蛋白的影响

IF 6.1 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Best practice & research. Clinical endocrinology & metabolism Pub Date : 2023-05-01 DOI:10.1016/j.beem.2022.101667
Connie B. Newman MD (Adjunct Professor of Medicine)
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引用次数: 4

摘要

内分泌疾病可能与血脂异常有关,并可能增加动脉粥样硬化性心血管疾病(ASCVD)的风险。本章描述了垂体、甲状腺、肾上腺、卵巢和睾丸疾病中脂质和脂蛋白的变化,这些变化的机制,这些内分泌疾病中的ASCVD风险,以及内分泌疾病的治疗是否改善了脂质状况并降低了ASCVD风险。肢端肥大症、生长激素缺乏、库欣综合征、慢性糖皮质激素替代、甲状腺功能减退、多囊卵巢综合征和男性性腺功能减退会增加LDL-C和/或TG。LDL-C的显著降低与甲状腺功能亢进有关,HDL-C水平极低与睾酮和/或其他合成代谢类固醇滥用有关。肢端肥大症、生长激素缺乏、库欣综合征和慢性糖皮质激素替代与ASCVD风险增加有关。肢端肥大症、生长激素缺乏症、甲状腺功能减退症、库欣综合征和睾酮缺乏症的治疗可以降低LDL-C,尽管可能仍需要他汀类药物治疗。对ASCVD的影响尚不清楚。
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Effects of endocrine disorders on lipids and lipoproteins

Endocrine diseases may be associated with dyslipidaemia and may increase atherosclerotic cardiovascular disease (ASCVD) risk. This chapter describes changes in lipids and lipoproteins in diseases of the pituitary, thyroid, adrenal glands, ovaries, and testes, the mechanisms for these changes, ASCVD risk in these endocrine disorders, and whether treatment of the endocrine disorder improves the lipid profile and reduces ASCVD risk. Acromegaly, GH deficiency, Cushing syndrome, chronic glucocorticoid replacement, hypothyroidism, PCOS and male hypogonadism can increase LDL-C and/or TG. Marked reductions in LDL-C are associated with hyperthyroidism, and extremely low HDL-C levels with testosterone and/or other anabolic steroid abuse. Acromegaly, GH deficiency, Cushing syndrome, and chronic glucocorticoid replacement are associated with increased ASCVD risk. Treatment of acromegaly, GH deficiency, hypothyroidism, Cushing syndrome, and testosterone deficiency reduce LDL-C, although statin therapy may still be needed. Effects on ASCVD are not known.

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来源期刊
CiteScore
11.90
自引率
0.00%
发文量
77
审稿时长
6-12 weeks
期刊介绍: Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management. Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.
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