Faculty of Medicine, Macau University of Science and Technology, Macau, China.
Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
Expert Rev Endocrinol Metab. 2020 May;15(3):147-157. doi: 10.1080/17446651.2020.1750949. Epub 2020 Apr 15.
: Postprandial hyperlipidemia is a common feature of the atherogenic dyslipidemia in patients with type 2 diabetes. Quantification of this with oral fat tolerance tests is not used routinely in clinical practice and abnormal postprandial lipids are usually inferred from non-fasting plasma triglyceride levels. Identifying excessive postprandial hyperlipidemia may help to refine cardiovascular risk assessment but there are no treatments currently available which selectively target postprandial lipids and no large cardiovascular outcome trials using this as the entry criterion.: In this review of relevant published material, we summarize the findings from the most important publications in this area.: Postprandial hyperlipidemia appears to contribute to the cardiovascular risk in patients with diabetes. Non-fasting triglyceride levels provide a surrogate marker of postprandial hyperlipidemia but more specific markers such as apoB48 levels may prove to be more reliable. Omega-3 fatty acids, fibrates and ezetimibe can reduce postprandial lipids but may not correct them completely. Several novel treatments have been developed to target hypertriglyceridemia and some of these may be particularly effective in improving postprandial levels. Further clinical trials are needed to establish the role of postprandial lipids in assessment of cardiovascular risk and to identify the most effective treatments.
餐后高脂血症是 2 型糖尿病患者致动脉粥样硬化性血脂异常的常见特征。口服脂肪耐量试验对其进行定量检测并未常规用于临床实践，通常从非空腹血浆甘油三酯水平推断出异常的餐后血脂。确定餐后血脂过高可能有助于完善心血管风险评估，但目前尚无专门针对餐后血脂的治疗方法，也没有使用该方法作为入选标准的大型心血管结局试验。
在对相关已发表文献的综述中，我们总结了该领域最重要的出版物的研究结果。
餐后高脂血症似乎会增加糖尿病患者的心血管风险。非空腹甘油三酯水平是餐后高脂血症的替代标志物，但更特异的标志物，如 apoB48 水平，可能更可靠。ω-3 脂肪酸、贝特类药物和依折麦布可降低餐后血脂，但可能无法完全纠正。已开发出几种新的治疗方法来靶向治疗高甘油三酯血症，其中一些方法可能在改善餐后血脂方面特别有效。需要进一步的临床试验来确定餐后血脂在心血管风险评估中的作用，并确定最有效的治疗方法。
