Yang Ye Seul, Kim Hack-Lyoung, Kim Sang-Hyun, Moon Min Kyong
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.
J Lipid Atheroscler. 2023 Jan;12(1):12-22. doi: 10.12997/jla.2023.12.1.12. Epub 2023 Jan 17.
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作为心血管疾病(CVD)的一个可改变风险因素,是一个重要的治疗靶点。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,实现这一目标仍未达到最佳效果。基于对CVD的准确风险评估来设定LDL-C控制的目标值很重要。在此,我们总结了糖尿病患者血脂管理的最新证据,并展示了韩国糖尿病协会和韩国脂质与动脉粥样硬化学会关于根据糖尿病病程、CVD的存在、靶器官损害或主要心血管危险因素制定LDL-C治疗目标的共识。对于2型糖尿病(T2DM)合并CVD的患者,建议LDL-C目标值<55 mg/dL,且LDL-C水平较基线降低50%或更多。对于糖尿病病程≥10年、有主要心血管危险因素或靶器官损害的T2DM患者,为预防CVD,建议LDL-C目标值<70 mg/dL。对于糖尿病病程<10年且无主要心血管危险因素的T2DM患者,建议LDL-C目标值<100 mg/dL。