Munigoti Srinivasa P, Harinarayan C V
Consultant Endocrinologist, Fortis Hospital, Bangalore, Karnataka, India.
Director, Institute of Endocrinology, Diabetes and Osteoporosis, Sakra World Hospitals, Marathahalli, Bangalore, Karnataka, India.
Indian J Endocrinol Metab. 2014 May;18(3):283-7. doi: 10.4103/2230-8210.131134.
A triad of high triglycerides, low high-density lipoprotein (HDL) cholesterol, and elevated small dense low-density lipoprotein particles occurring in a patient with type 2 diabetes is referred to atherogenic diabetic dyslipidemia (ADD). Despite statin therapy, a significant residual risk remains potentially attributable to increased triglyceride concentration and low HDL cholesterol, a characteristic hallmark of ADD. Current therapeutic options in reducing this residual risk include nicotinic acid, omega 3 fatty acids, and selective peroxisome proliferator-activated receptor-alpha (PPAR) agonists (fibrates). These drugs are limited in their potential either by lack of evidence to support their role in reducing cardiovascular events or due to their side effects. This review details their current status and also the role of new glitazar, saroglitazar adual PPARα/γ agonist with predominant PPARα activity in the management of ADD.
2型糖尿病患者出现高甘油三酯、低高密度脂蛋白（HDL）胆固醇和升高的小而密低密度脂蛋白颗粒三联征，被称为动脉粥样硬化性糖尿病血脂异常（ADD）。尽管使用了他汀类药物治疗，但仍存在显著的残余风险，这可能归因于甘油三酯浓度升高和HDL胆固醇降低，这是ADD的一个特征性标志。目前降低这种残余风险的治疗选择包括烟酸、ω-3脂肪酸和选择性过氧化物酶体增殖物激活受体-α（PPAR）激动剂（贝特类药物）。这些药物的潜力有限，要么缺乏支持其在降低心血管事件中作用的证据，要么因其副作用。本综述详细介绍了它们的现状，以及新型格列他唑（具有主要PPARα活性的双重PPARα/γ激动剂）在ADD管理中的作用。
