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西太平洋地区亚洲人群的糖尿病血脂异常:已知与未知。

Diabetic dyslipidaemia in Asian populations in the Western Pacific Region: what we know and don't know.

机构信息

Hong Kong Institute of Diabetes and Obesity and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong Special Administrative Region.

出版信息

Diabetes Res Clin Pract. 2011 Oct;94(1):1-13. doi: 10.1016/j.diabres.2011.05.034. Epub 2011 Jul 13.

Abstract

Approximately 77 million persons with diabetes reside in the Western Pacific Region. This number is estimated to rise to 113 million in 2030 with increasing burden of cardio-renal disease, affecting an increasingly young population. Randomized clinical trials have confirmed the benefits of using statins to reduce low-density lipoprotein cholesterol in preventing cardiovascular disease (CVD) in Caucasians, although similar data are lacking in Asia. Experts from the Western Pacific Region met and reviewed evidence regarding risk association of diabetic dyslipidaemia with cardio-renal disease, effects of lipid lowering, recommended guidelines and clinical practices in Asian populations. There is strong evidence supporting the role of diabetic dyslipidaemia in cardio-renal disease and the benefits of lipid lowering in these populations. The high rate of diabetic kidney disease, its close links with CVD, and the benefits of lipid lowering on renal function are particularly relevant to this population. While most national guidelines use criteria similar to the West in management of diabetic dyslipidaemia, there are consistently low rates of use of lipid-lowering drugs and attaining treatment goals in the region. The group recommends conducting randomized studies, strengthening of the health care system to promote early detection, and intervention of diabetic dyslipidaemia to prevent end organ damage.

摘要

大约有 7700 万糖尿病患者居住在西太平洋地区。预计到 2030 年,由于心血管和肾脏疾病负担不断增加,这一数字将上升至 1.13 亿,且受影响的人群日趋年轻化。尽管亚洲缺乏类似的数据,但随机临床试验已证实使用他汀类药物降低低密度脂蛋白胆固醇可预防心血管疾病(CVD)。来自西太平洋地区的专家开会并审查了有关糖尿病血脂异常与心血管和肾脏疾病风险关联、降脂效果、亚洲人群的推荐指南和临床实践的证据。有强有力的证据表明糖尿病血脂异常在心血管和肾脏疾病中的作用,以及在这些人群中降脂的益处。糖尿病肾病的高发病率及其与 CVD 的密切关系,以及降脂对肾功能的益处,对该人群尤为重要。虽然大多数国家的指南在管理糖尿病血脂异常方面使用与西方类似的标准,但该地区降脂药物的使用率和达标率一直较低。专家组建议开展随机研究,加强卫生保健系统以促进早期发现,并干预糖尿病血脂异常以预防终末器官损伤。

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