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与内分泌紊乱相关的脂类谱异常。

Lipid profile abnormalities associated with endocrine disorders.

机构信息

Department of Endocrinology, Metabolism, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.

Department of Paediatric Cardiology, University of Medical Sciences, Poznan, Poland.

出版信息

Endokrynol Pol. 2022;73(5):863-871. doi: 10.5603/EP.a2022.0059. Epub 2022 Aug 16.

Abstract

Nearly 30% of patients with lipid profile abnormalities suffer from secondary dyslipidaemias. Endocrine disorders are one of the most important causes of dyslipidaemia. Dyslipidaemia can be observed in the pathologies of a variety of endocrine glands, including the thyroid, the pituitary, the adrenals, and the gonads. The most common endocrinopathy causing dyslipidaemia is hypothyroidism. In this paper, we review the lipid profile alterations observed in endocrinopathies. We describe changes in classic lipid profile parameters, including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. However, we also focus on the influence of endocrine disorders on relatively new cardiovascular markers such as apolipoprotein B, apolipoprotein A1, and lipoprotein(a). While almost all endocrinopathies cause detrimental changes to the lipid profile, hyperthyroidism seems to be a disorder in which lowering of such parameters as total cholesterol, low-density cholesterol, and triglycerides can be observed. Comprehensive screening for endocrine disorders should always be included in the differential diagnostic process of secondary causes of dyslipidaemia. Early detection and treatment of endocrinopathy have a considerable impact on a patient's health. Proper treatment of those disorders plays a crucial role in modifying the cardiovascular risk and improving the lipid profile of those patients. Even though lipid-lowering therapy is usually still needed, in some cases restoration of hormonal balance might be sufficient to normalize the lipid profile abnormalities.

摘要

近 30%的血脂异常患者患有继发性血脂异常。内分泌紊乱是血脂异常的重要原因之一。血脂异常可发生于多种内分泌腺体的疾病中,包括甲状腺、垂体、肾上腺和性腺。引起血脂异常最常见的内分泌疾病是甲状腺功能减退症。本文综述了内分泌疾病中血脂谱的改变。我们描述了经典血脂参数的变化,包括总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯。然而,我们还关注了内分泌紊乱对载脂蛋白 B、载脂蛋白 A1 和脂蛋白(a)等相对较新的心血管标志物的影响。虽然几乎所有的内分泌疾病都会导致血脂谱的不良变化,但甲状腺功能亢进症似乎是一种总胆固醇、低密度胆固醇和甘油三酯等参数降低的疾病。全面筛查内分泌疾病应始终包括继发性血脂异常的鉴别诊断过程。早期发现和治疗内分泌疾病对患者的健康有很大影响。适当治疗这些疾病对于改变心血管风险和改善这些患者的血脂谱至关重要。尽管通常仍需要降脂治疗,但在某些情况下,恢复激素平衡可能足以使血脂异常正常化。

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