Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford OX3 7LF, UK.
Endocrinol Metab Clin North Am. 2022 Sep;51(3):681-690. doi: 10.1016/j.ecl.2022.01.005. Epub 2022 Jul 4.
Combinations of lipid-lowering agents can often bring LDL cholesterol down to around 40 mg/dL (1 mmol/L). Randomized controlled trials indicate that this reduces the risk of atherosclerotic vascular events with minimal adverse effects. This has raised the question of whether there is any concentration of LDL cholesterol below which further lowering is futile and/or a source of new adverse effects. This article examines several lines of evidence that lead to the conclusion that there is no known threshold below which lowering LDL cholesterol is harmful, but reduction of LDL cholesterol below 25 mg/dL may provide little if any further benefit.
降脂药物的联合应用通常可以使 LDL 胆固醇降低到约 40mg/dL（1mmol/L）。随机对照试验表明，这可以降低动脉粥样硬化性血管事件的风险，而不良反应最小。这就提出了一个问题，即是否存在 LDL 胆固醇浓度低于该浓度时，进一步降低 LDL 胆固醇既无效又/或会产生新的不良反应。本文探讨了几条导致 LDL 胆固醇降低无害的证据线，但是将 LDL 胆固醇降低到 25mg/dL 以下可能不会带来太多益处，甚至可能没有益处。
