University of Ulm Medical Center, Department of Internal Medicine II - Cardiology, Albert-Einstein-Allee 23, D-89081 Ulm, Germany.
Best Pract Res Clin Endocrinol Metab. 2014 Jun;28(3):281-94. doi: 10.1016/j.beem.2014.01.003. Epub 2014 Jan 15.
Considerable progress has been achieved in the treatment of dyslipidemias. However, half of cardiovascular events occur in individuals with average or low cholesterol levels and there is still a considerable residual risk with 70% of patients having an event despite statin treatment. In the era of personalized medicine there is increased interest in the incorporation of individual biomarkers in risk score algorithms in order to improve cardiovascular risk stratification followed by the prompt initiation of preventive measures. Since the 2001 third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment on High Blood Cholesterol in Adults (ATP III) several studies have evaluated the prognostic value of lipid related biomarkers such as non-HDL-cholesterol, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, lipoprotein(a), lipoprotein-associated phospholipase A2, and C-reactive protein. This article tries to summarize the most recent results in this area.
在治疗血脂异常方面已经取得了相当大的进展。然而,一半的心血管事件发生在胆固醇水平中等或较低的个体中,并且仍然存在相当大的残余风险,尽管 70%的患者接受了他汀类药物治疗,但仍有事件发生。在个性化医学时代,人们越来越关注将个体生物标志物纳入风险评分算法中,以改善心血管风险分层,随后及时采取预防措施。自 2001 年美国国家胆固醇教育计划专家小组第三次报告(ATP III)以来,多项研究评估了非高密度脂蛋白胆固醇、载脂蛋白 B、载脂蛋白 B/载脂蛋白 A1 比值、脂蛋白(a)、脂蛋白相关磷脂酶 A2 和 C 反应蛋白等与脂质相关的生物标志物的预后价值。本文试图总结该领域的最新研究结果。