Department of Cardiology, St George's Hospital, London, UK.
Myocardial Function Section, Imperial Centre for Translational and Experimental Medicine, Imperial College London, London, UK.
Diabetes Obes Metab. 2019 Apr;21 Suppl 1:6-16. doi: 10.1111/dom.13691.
Atherosclerotic cardiovascular events are the leading cause of mortality and morbidity in those with diabetes. A key contributor to the development of atherosclerosis in this population is the presence of a particularly atherogenic lipid profile often referred to as 'Diabetic Dyslipidemia'. This profile is characterized by elevated triglycerides, triglyceride-rich lipoproteins, small dense LDL particles, and reduced HDL levels. This article reviews the underlying aetiology and pathophysiology of this dyslipidaemia and atherosclerosis in those with diabetes, provides insights from epidemiological and genetic studies, and current cardiovascular risk reducing interventions including novel therapies such as PCSK-9 inhibitors.
动脉粥样硬化性心血管事件是糖尿病患者死亡和发病的主要原因。导致该人群动脉粥样硬化发展的一个关键因素是存在一种特别促动脉粥样硬化的脂质谱，通常称为“糖尿病血脂异常”。这种特征是甘油三酯升高、富含甘油三酯的脂蛋白、小而密的 LDL 颗粒和 HDL 水平降低。本文综述了糖尿病患者血脂异常和动脉粥样硬化的潜在病因和病理生理学，提供了来自流行病学和遗传学研究的见解，以及目前包括 PCSK-9 抑制剂在内的新型治疗方法在内的心血管风险降低干预措施。
