Farnier Michel
Point Médical, Rond Point de la Nation, Dijon, France.
Atheroscler Suppl. 2015 Feb;17:2-8. doi: 10.1016/S1567-5688(15)50002-0.
Patients with diabetes represent a population at higher risk for cardiovascular disease. Diabetic dyslipidemia is characterized by the so-called atherogenic lipid triad, consisting of an increase in small dense low density lipoprotein particles and in triglyceride-rich lipoproteins, and a decrease in high-density lipoprotein cholesterol, with an increase in non-HDL cholesterol. Numerous trials have investigated the efficacy of add-on ezetimibe therapy for patients with type 2 diabetes and not controlled by statin therapy. The published data highly suggest that patients with type 2 diabetes may be more likely to benefit from ezetimibe/statin combination therapy. However, evidence specifically addressing hard clinical endpoints and prospective trials addressing differences in response between patients with or without diabetes are still needed.
糖尿病患者是心血管疾病风险较高的人群。糖尿病血脂异常的特征是所谓的致动脉粥样硬化脂质三联征,包括小而密的低密度脂蛋白颗粒和富含甘油三酯的脂蛋白增加,高密度脂蛋白胆固醇降低,非高密度脂蛋白胆固醇增加。许多试验研究了依折麦布联合治疗对他汀类药物治疗未达标的2型糖尿病患者的疗效。已发表的数据强烈表明,2型糖尿病患者可能更有可能从依折麦布/他汀类药物联合治疗中获益。然而,仍需要专门针对硬临床终点的证据以及针对糖尿病患者与非糖尿病患者反应差异的前瞻性试验。