Lorenzatti Alberto J, Toth Peter P
DAMIC Medical Institute, Rusculleda Foundation for Research, Cordoba, Argentina.
Department of Cardiology, Cordoba Hospital, Cordoba, Argentina.
Eur Cardiol. 2020 Feb 26;15:1-9. doi: 10.15420/ecr.2019.06. eCollection 2020 Feb.
Over the past few decades, atherogenic dyslipidaemia has become one of the most common phenotypic presentations of lipid abnormalities, being strongly and unequivocally associated with an increased risk of cardiovascular (CV) disease. Despite the excellent results achieved from statin and non-statin management of LDL cholesterol and CV events prevention, there still remains a significant residual risk, associated with the prevalence of non-LDL cholesterol lipid patterns characterised by elevated triglyceride levels, low HDL cholesterol, a preponderance of small and dense LDL particles, accumulation of remnant lipoproteins and postprandial hyperlipidaemia. These qualitative and quantitative lipid modifications are largely associated with insulin resistance, type 2 diabetes and obesity, the prevalence of which has grown to epidemic proportions throughout the world. In this review, we analyse the pathophysiology of this particular dyslipidaemia, its relationship with the development of atherosclerotic CV disease and, finally, briefly describe the therapeutic approaches, including changes in lifestyle and current pharmacological interventions to manage these lipid alterations aimed at preventing CV events.
在过去几十年中，致动脉粥样硬化性血脂异常已成为脂质异常最常见的表型之一，与心血管（CV）疾病风险增加密切且明确相关。尽管他汀类药物和非他汀类药物在管理低密度脂蛋白胆固醇及预防CV事件方面取得了优异成果，但仍存在显著的残余风险，这与以甘油三酯水平升高、高密度脂蛋白胆固醇水平低、小而密的低密度脂蛋白颗粒占优势、残余脂蛋白积聚和餐后高脂血症为特征的非低密度脂蛋白胆固醇血脂模式的流行有关。这些定性和定量的脂质改变在很大程度上与胰岛素抵抗、2型糖尿病和肥胖有关，而这些疾病在全球的患病率已呈流行趋势。在本综述中，我们分析了这种特殊血脂异常的病理生理学、其与动脉粥样硬化性CV疾病发展的关系，最后简要描述了治疗方法，包括生活方式的改变以及目前用于管理这些脂质改变以预防CV事件的药物干预措施。
