Division of Endocrinology, Diabetes and Metabolism, Diabetes Research Institute, University of Miami Miller School of Medicine, 1450 Northwest 10th Avenue, Miami, FL 33136, USA.
Endocrinol Metab Clin North Am. 2022 Sep;51(3):603-624. doi: 10.1016/j.ecl.2022.02.011. Epub 2022 Jul 4.
Elevated triglyceride and reduced high-density lipoprotein cholesterol (HDL-C) are common in type 2 diabetes, but increased atherogenic particles and dysfunctional HDL are demonstrable in both types 1 and 2 diabetes, contributing to a two-fold increase in atherosclerotic cardiovascular disease (ASCVD). ASCVD risk accelerates with diabetes duration and severity, aging, risk factors, and risk enhancers. Using statins or other LDL-C-lowering agents if needed in adults with intermediate or greater degrees of risk is recommended. Although hypertriglyceridemia enhances risk, most guidelines do not recommend fibrates or omega 3 fatty acid for risk reduction except for icosapent ethyl in patients with ASCVD.
升高的甘油三酯和降低的高密度脂蛋白胆固醇（HDL-C）在 2 型糖尿病中很常见，但在 1 型和 2 型糖尿病中都可检测到致动脉粥样硬化颗粒增加和功能失调的 HDL，导致动脉粥样硬化性心血管疾病（ASCVD）风险增加一倍。ASCVD 风险随糖尿病病程和严重程度、年龄、危险因素和风险增强因素而加速。建议在具有中危或高危程度的成年人中，如果需要，使用他汀类药物或其他 LDL-C 降低药物。虽然高甘油三酯血症会增加风险，但大多数指南不建议使用贝特类药物或ω-3 脂肪酸来降低风险，除了 ASCVD 患者的二十碳五烯酸乙酯。
