University of Chicago, Pritzker School of Medicine, Radiant Research, 5758 S. Maryland Ave, MC 9024, Chicago, IL 60637-1470, USA.
J Clin Lipidol. 2008 Apr;2(2):S29-33. doi: 10.1016/j.jacl.2008.01.009.
The digestive tract plays a key role in lipid metabolism and in cardiovascular risk through the physiology of bile acids on lipid absorption, enterohepatic recycling of bile acids, and cholesterol oxidation in synthesis of bile acids. Recent evidence associates the activation of farnesoid X receptor by bile acids with alterations in high-density lipoprotein cholesterol, triglyceride metabolism, and glucose metabolism. Bile-acid sequestrants augment cholesterol excretion via enhanced conversion to bile acids to lower low-density lipoprotein cholesterol. Several recent studies have demonstrated a role for the bile-acid sequestrant colesevelam hydrochloride in improving glycemic control as well as lipid profiles in subjects with type 2 diabetes. This work reviews the mechanisms of action of colesevelam hydrochloride in interrupting bile acid reabsorption and in lipid transport and glucose control.
消化道在脂质代谢和心血管风险中起着关键作用，其作用机制包括胆汁酸对脂质吸收的生理学作用、胆汁酸的肠肝循环以及胆固醇在胆汁酸合成中的氧化。最近的证据表明，胆汁酸激活法尼醇 X 受体可改变高密度脂蛋白胆固醇、甘油三酯代谢和葡萄糖代谢。胆汁酸螯合剂通过增强转化为胆汁酸来增加胆固醇排泄，从而降低低密度脂蛋白胆固醇。最近的几项研究表明，胆汁酸螯合剂考来维仑盐酸盐在改善 2 型糖尿病患者的血糖控制和血脂谱方面发挥了作用。本文综述了考来维仑盐酸盐通过中断胆汁酸重吸收以及脂质转运和葡萄糖控制来发挥作用的机制。
