Newman Connie B
Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, NY 10016, USA.
Best Pract Res Clin Endocrinol Metab. 2023 May;37(3):101667. doi: 10.1016/j.beem.2022.101667. Epub 2022 May 10.
Endocrine diseases may be associated with dyslipidaemia and may increase atherosclerotic cardiovascular disease (ASCVD) risk. This chapter describes changes in lipids and lipoproteins in diseases of the pituitary, thyroid, adrenal glands, ovaries, and testes, the mechanisms for these changes, ASCVD risk in these endocrine disorders, and whether treatment of the endocrine disorder improves the lipid profile and reduces ASCVD risk. Acromegaly, GH deficiency, Cushing syndrome, chronic glucocorticoid replacement, hypothyroidism, PCOS and male hypogonadism can increase LDL-C and/or TG. Marked reductions in LDL-C are associated with hyperthyroidism, and extremely low HDL-C levels with testosterone and/or other anabolic steroid abuse. Acromegaly, GH deficiency, Cushing syndrome, and chronic glucocorticoid replacement are associated with increased ASCVD risk. Treatment of acromegaly, GH deficiency, hypothyroidism, Cushing syndrome, and testosterone deficiency reduce LDL-C, although statin therapy may still be needed. Effects on ASCVD are not known.
内分泌疾病可能与血脂异常相关，并可能增加动脉粥样硬化性心血管疾病（ASCVD）风险。本章描述了垂体、甲状腺、肾上腺、卵巢和睾丸疾病中脂质和脂蛋白的变化、这些变化的机制、这些内分泌疾病中的ASCVD风险，以及内分泌疾病的治疗是否能改善血脂谱并降低ASCVD风险。肢端肥大症、生长激素缺乏症、库欣综合征、慢性糖皮质激素替代治疗、甲状腺功能减退症、多囊卵巢综合征和男性性腺功能减退症可增加低密度脂蛋白胆固醇（LDL-C）和/或甘油三酯（TG）。甲状腺功能亢进症与LDL-C显著降低有关，而睾酮和/或其他合成代谢类固醇滥用与极低的高密度脂蛋白胆固醇（HDL-C）水平有关。肢端肥大症、生长激素缺乏症、库欣综合征和慢性糖皮质激素替代治疗与ASCVD风险增加有关。肢端肥大症、生长激素缺乏症、甲状腺功能减退症、库欣综合征和睾酮缺乏症的治疗可降低LDL-C，尽管可能仍需要他汀类药物治疗。对ASCVD的影响尚不清楚。
