Demant T
Institut für Labormedizin, Städtisches Krankenhaus Dresden-Friedrichstadt.
Fortschr Med Orig. 2001;119(1):37-40.
Dyslipoproteinemia associated with type 2 diabetes comprises hypertriglyceridemia caused by reduced insulin sensitivity, and consequently, low HDL levels and an increase in the proportion of small dense LDL particles. In addition, in both type 1 and 2 diabetes glycated LDL is formed in the presence of high plasma glucose levels. These lipoprotein disorders are all atherogenic and are responsible for the distinctly increased risk for cardiovascular disease in diabetics. Intensive glucose-lowering measures result in lower rates of micro- and macro-angiopathies in both types of diabetes. The benefit of additional lipid-lowering measures has not yet been confirmed by appropriate investigations. However, subgroup analyses from two large intervention trials do demonstrate that mortality from coronary heart disease may be substantially reduced. LDL cholesterol levels in diabetics should not exceed 115 mg/dl (3 mmol/l), and fasting triglycerides should be lower than 180 mg/dL (2 mmol/l).
与2型糖尿病相关的脂蛋白异常血症包括因胰岛素敏感性降低导致的高甘油三酯血症，以及随之而来的低高密度脂蛋白水平和小而密低密度脂蛋白颗粒比例增加。此外，在1型和2型糖尿病中，高血糖水平下均会形成糖化低密度脂蛋白。这些脂蛋白紊乱都具有致动脉粥样硬化性，是糖尿病患者心血管疾病风险显著增加的原因。强化降糖措施可降低两种类型糖尿病的微血管和大血管病变发生率。额外降脂措施的益处尚未得到适当研究的证实。然而，两项大型干预试验的亚组分析确实表明，冠心病死亡率可能会大幅降低。糖尿病患者的低密度脂蛋白胆固醇水平不应超过115mg/dl（3mmol/l），空腹甘油三酯应低于180mg/dL（2mmol/l）。
