Pathogenesis and Management of Diabetic Dyslipidemia
作者:
Elena Izkhakov,
Eyal Meltzer,
Ardon Rubinstein,
期刊:
Treatments in Endocrinology
(ADIS Available online 2003)
卷期:
Volume 2,
issue 4
页码: 231-245
ISSN:1175-6349
年代: 2003
出版商: ADIS
关键词: Lipid metabolism disorders, treatment;HMG CoA reductase inhibitors, therapeutic use;Fibric acid derivatives, therapeutic use;Nicotinic acid, therapeutic use;Bile acid binding agents, therapeutic use;Diabetic complications, treatment
数据来源: ADIS
摘要:
Patients with diabetes mellitus have a 2- to 4-fold increased risk of atherosclerotic cardiovascular, peripheral vascular, and cerebrovascular disease, which are the leading causes of morbidity and mortality in this population.Several epidemiological studies have shown an association between diabetic dyslipidemia, which is characterized by hypertriglyceridemia, low levels of high density lipoprotein-cholesterol, postprandial lipemia and small, dense low density lipoprotein-cholesterol (LDL-C) particles, and the occurrence of cardiovascular disease. Other studies have established the beneficial effects of lipid lowering on the reduction of major coronary events in diabetic patients.The recent National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines emphasize diabetes as a coronary heart disease risk equivalent. The NCEP ATP III states that elevated LDL-C is a major risk factor for coronary heart disease, and the primary goal of risk-reduction therapy is the reduction of LDL-C levels to 100 mg/dL.This article defines and describes diabetic dyslipidemia and its etiology and pathogenesis, as well as reviewing guidelines and recommendations for treatment of this disorder. Treatment of diabetic dyslipidemia includes 1) lifestyle modifications: physical activity and a diet low in saturated fats and cholesterol and high in complex carbohydrates and fiber; and 2) pharmacological treatment withoral antihyperglycemic agents: metformin and thiazolidinediones;weight reduction drugs: orlistat and sibutramine and;lipid-lowering drugs: HMG-CoA reductase inhibitors, fibric acid derivatives, nicotinic acid, and bile acid sequestrants.
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