Council for Responsible Nutrition, Washington, DC 20036, USA.
Nutr Rev. 2012 Jun;70(6):357-66. doi: 10.1111/j.1753-4887.2012.00479.x.
Elevated low-density lipoprotein cholesterol (LDL-C) has been the main target of lipid-altering therapy to reduce cardiovascular risk associated with dyslipidemia. Residual cardiovascular risk remains, however, after achievement of goal LDL-C levels and is associated in part with other risk markers of cardiovascular disease, including low high-density lipoprotein cholesterol (HDL-C), high lipoprotein a, and hypertriglyceridemia. Niacin is considered a valuable agent for therapy to modify high LDL-C as well as low HDL-C, high lipoprotein a, and hypertriglyceridemia. The forms of niacin available in the marketplace include unbound niacin, or free nicotinic acid (NA); extended-release NA, a form of NA that is released gradually over a period of time; inositol hexanicotinate, six molecules of NA covalently bonded to one molecule of inositol; and nicotinamide, or niacinamide, the amide form of NA, which is readily bioavailable. This review is designed to assist healthcare professionals in evaluating the form(s) of niacin best suited for a particular therapeutic goal. Further, it provides a literature-based evaluation of risk for NA, extended-release NA, inositol hexanicotinate, and nicotinamide.
升高的低密度脂蛋白胆固醇（LDL-C）一直是降脂治疗降低与血脂异常相关心血管风险的主要靶点。然而，在达到目标 LDL-C 水平后，仍存在残余心血管风险，部分与心血管疾病的其他风险标志物相关，包括低高密度脂蛋白胆固醇（HDL-C）、高脂蛋白(a)和高三酰甘油血症。烟酸被认为是一种有价值的治疗药物，可用于改善高 LDL-C 以及低 HDL-C、高脂蛋白(a)和高三酰甘油血症。市场上可用的烟酸形式包括未结合的烟酸，或游离烟碱酸（NA）；缓释 NA，一种在一段时间内逐渐释放的 NA 形式；肌醇六烟酸酯，六分子 NA 与一分子肌醇共价结合；以及烟酰胺，或烟酸酰胺，NA 的酰胺形式，其易于生物利用。本综述旨在帮助医疗保健专业人员评估最适合特定治疗目标的烟酸形式。此外，还基于文献评估了 NA、缓释 NA、肌醇六烟酸酯和烟酰胺的风险。
