Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Diabetes Metab J. 2023 Jan;47(1):1-9. doi: 10.4093/dmj.2022.0448. Epub 2023 Jan 20.
Dyslipidemia in patients with diabetes is an important treatment target as a modifiable risk factor for cardiovascular disease (CVD). Although the primary treatment goal for dyslipidemia is to control low-density lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal according to recent studies. It is important to set the target goal for LDL-C control based on an accurate risk assessment for CVD. Here, we summarize the latest evidence on lipid management in patients with diabetes and present a consensus of the Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis on the treatment goals of LDL-C according to the duration of diabetes, presence of CVD, target organ damage, or major cardiovascular risk factors. In patients with type 2 diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a reduction in LDL-C level by 50% or more from the baseline is recommended. For the primary prevention of CVD in patients with T2DM with a duration of diabetes ≥10 years, major cardiovascular risk factors, or target organ damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM with a duration of diabetes <10 years and no major cardiovascular risk factors, an LDL-C goal of <100 mg/dL is recommended.
糖尿病患者的血脂异常是心血管疾病（CVD）的一个重要治疗靶点，因为它是可改变的危险因素。尽管血脂异常的主要治疗目标是控制低密度脂蛋白胆固醇（LDL-C），但根据最近的研究，这一目标仍未达到。根据 CVD 的准确风险评估，为 LDL-C 控制设定目标是很重要的。在这里，我们总结了糖尿病患者血脂管理的最新证据，并提出了韩国糖尿病协会和韩国血脂和动脉粥样硬化学会的共识，即根据糖尿病的持续时间、CVD 的存在、靶器官损伤或主要心血管危险因素，对 LDL-C 的治疗目标进行建议。对于有 CVD 的 2 型糖尿病（T2DM）患者，建议 LDL-C 目标值<55mg/dL，并使 LDL-C 水平比基线降低 50%或更多。对于糖尿病持续时间≥10 年、有主要心血管危险因素或靶器官损伤的 T2DM 患者，建议 CVD 的一级预防 LDL-C 目标值<70mg/dL。对于糖尿病持续时间<10 年且无主要心血管危险因素的 T2DM 患者，建议 LDL-C 目标值<100mg/dL。
