School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
BMC Endocr Disord. 2024 Jan 2;24(1):4. doi: 10.1186/s12902-023-01526-9.
The current systematic review aimed to elucidate the effects of lipid variability on microvascular complication risk in diabetic patients. The lipid components studied were as follows: High-density lipoprotein (HDL), High-density lipoprotein (LDL), Triglyceride (TG), Total Cholesterol (TC), and Remnant Cholesterol (RC).
We carried out a systematic search in multiple databases, including PubMed, Web of Science, and SCOPUS, up to October 2nd, 2023. After omitting the duplicates, we screened the title and abstract of the studies. Next, we retrieved and reviewed the full text of the remaining articles and included the ones that met our inclusion criteria in the study.
In this research, we examined seven studies, comprising six cohort studies and one cross-sectional study. This research was conducted in Hong Kong, China, Japan, Taiwan, Finland, and Italy. The publication years of these articles ranged from 2012 to 2022, and the duration of each study ranged from 5 to 14.3 years. The study group consisted of patients with type 2 diabetes aged between 45 and 84 years, with a diabetes history of 7 to 12 years. These studies have demonstrated that higher levels of LDL, HDL, and TG variability can have adverse effects on microvascular complications, especially nephropathy and neuropathic complications. TG and LDL variability were associated with the development of albuminuria and GFR decline. Additionally, reducing HDL levels showed a protective effect against microalbuminuria. However, other studies did not reveal an apparent relationship between lipid variations and microvascular complications, such as retinopathy. Current research lacks geographic and demographic diversity. Increased HDL, TG, and RC variability have been associated with several microvascular difficulties. Still, the pathogenic mechanism is not entirely known, and understanding how lipid variability affects microvascular disorders may lead to novel treatments. Furthermore, the current body of this research is restricted in its coverage. This field's lack of thorough investigations required a more extensive study and comprehensive effort.
The relationship between lipid variation (LDL, HDL, and TG) (adverse effects) on microvascular complications, especially nephropathy and neuropathic (and maybe not retinopathy), is proven. Physicians and health policymakers should be highly vigilant to lipid variation in a general population.
本系统评价旨在阐明血脂变异性对糖尿病患者微血管并发症风险的影响。所研究的血脂成分如下：高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯（TG）、总胆固醇（TC）和残余胆固醇（RC）。
我们在多个数据库（包括 PubMed、Web of Science 和 SCOPUS）中进行了系统搜索，截至 2023 年 10 月 2 日。剔除重复项后，我们筛选了研究的标题和摘要。然后，我们检索并审查了其余文章的全文，并将符合纳入标准的文章纳入研究。
本研究共纳入 7 项研究，包括 6 项队列研究和 1 项横断面研究。这些研究分别在中国香港、日本、中国台湾、芬兰和意大利进行。这些文章的发表年份从 2012 年到 2022 年不等，每项研究的持续时间从 5 年到 14.3 年不等。研究组由年龄在 45 岁至 84 岁之间、糖尿病病史 7 至 12 年的 2 型糖尿病患者组成。这些研究表明，LDL、HDL 和 TG 变异性增加对微血管并发症有不良影响，尤其是肾病和神经病变并发症。TG 和 LDL 变异性与白蛋白尿和 GFR 下降的发展有关。此外，降低 HDL 水平对微量白蛋白尿具有保护作用。然而，其他研究并未显示脂质变化与微血管并发症（如视网膜病变）之间存在明显关系。目前的研究缺乏地域和人口统计学的多样性。升高的 HDL、TG 和 RC 变异性与多种微血管困难有关。然而，其发病机制尚不完全清楚，了解脂质变异性如何影响微血管疾病可能会导致新的治疗方法。此外，目前这方面的研究范围有限。该领域缺乏彻底的研究，需要更广泛的研究和全面的努力。
证明了血脂变化（LDL、HDL 和 TG）（不良影响）与微血管并发症（特别是肾病和神经病变（可能不是视网膜病变））之间的关系。医生和卫生政策制定者应高度警惕普通人群中的血脂变化。
