脂蛋白(a)与糖尿病：病因与后果。
Lipoprotein (a) and diabetes mellitus: causes and consequences.
机构信息
School of Public Health, Curtin University.
School of Medicine, University of Western Australia.
出版信息
Curr Opin Endocrinol Diabetes Obes. 2021 Apr 1;28(2):181-187. doi: 10.1097/MED.0000000000000597.
PURPOSE OF REVIEW
This review provides an update on the role of lipoprotein (a) [Lp(a)] in diabetes, including its impact as a risk factor as well as its contribution to the development of cardiovascular disease.
RECENT FINDINGS
Although a specific role for Lp(a) has not yet been conclusively established, it appears to have an inverse association with risk of diabetes. Several population-based studies have demonstrated associations between low levels of Lp(a) and increased risk of type 2 diabetes, but Mendelian randomization studies do not consistently support causality. Conversely, in patients with type 2 diabetes, elevated Lp(a) levels are associated with an increased risk of cardiovascular events.
SUMMARY
Although Lp(a) contributes to the development of cardiovascular disease in patients with diabetes, few trials have investigated the benefits of reducing Lp(a) within this patient population. Furthermore, guidelines do not specifically address the risk associated with elevated Lp(a) levels. Despite this, Lp(a) should be measured in patients with diabetes and considered when evaluating their overall risk burden.
目的综述
本综述介绍了脂蛋白 (a) [Lp(a)] 在糖尿病中的作用的最新进展，包括其作为危险因素的影响以及对心血管疾病发展的贡献。
最近的发现
尽管脂蛋白 (a) 的具体作用尚未得到明确证实，但它似乎与糖尿病风险呈负相关。几项基于人群的研究表明，Lp(a) 水平低与 2 型糖尿病风险增加之间存在关联，但孟德尔随机化研究并不一致支持因果关系。相反，在 2 型糖尿病患者中，Lp(a) 水平升高与心血管事件风险增加相关。
总结
尽管 Lp(a) 会导致糖尿病患者发生心血管疾病，但很少有试验研究降低该患者群体中 Lp(a) 的益处。此外，指南并未专门针对升高的 Lp(a) 水平相关风险进行阐述。尽管如此，仍应在糖尿病患者中测量 Lp(a)，并在评估其整体风险负担时加以考虑。
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