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神经退行性疾病中的脂质代谢与他汀类药物治疗:内分泌视角

Lipid Metabolism and Statin Therapy in Neurodegenerative Diseases: An Endocrine View.

作者信息

Di Sarno Antonella, Romano Fiammetta, Arianna Rossana, Serpico Domenico, Lavorgna Mariarosaria, Savastano Silvia, Colao Annamaria, Di Somma Carolina

机构信息

Section of Endocrinology, Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80138 Naples, Italy.

UNESCO Chair "Education for Health and Sustainable Development", University of Naples Federico II, 80138 Naples, Italy.

出版信息

Metabolites. 2025 Apr 18;15(4):282. doi: 10.3390/metabo15040282.

Abstract

: A growing body of evidence suggests a link between dyslipidemias and neurodegenerative diseases, highlighting the crucial role of lipid metabolism in the health of the central nervous system. The aim of our work was to provide an update on this topic, with a focus on clinical practice from an endocrinological point of view. Endocrinologists, being experts in the management of dyslipidemias, can play a key role in the prevention and treatment of neurodegenerative conditions, through precocious and effective lipid profile optimization. : The literature was scanned to identify clinical trials and correlation studies on the association between dyslipidemia, statin therapy, and the following neurodegenerative diseases: Alzheimer's disease (AD), Parkisons's disease (PD), Multiple sclerosis (MS), and Amyotrophic lateral sclerosis (ALS). : Impaired lipid homeostasis, such as that frequently observed in patients affected by obesity and diabetes, is related to neurodegenerative diseases, such as AD, PD, and other cognitive deficits related to aging. AD and related dementias are now a real priority health problem. In the United States, there are approximately 7 million subjects aged 65 and older living with AD and related dementias, and this number is projected to grow to 12 million in the coming decades. Lipid-lowering therapy with statins is an effective strategy in reducing serum low-density lipoprotein cholesterol to normal range concentrations and, therefore, cardiovascular disease risk; moreover, statins have been reported to have a positive effect on neurodegenerative diseases. : Several pieces of research have found inconsistent information following our review. There was no association between statin use and ALS incidence. More positive evidence has emerged regarding statin use and AD/PD. However, further large-scale prospective randomized control trials are required to properly understand this issue.

摘要

越来越多的证据表明血脂异常与神经退行性疾病之间存在联系,凸显了脂质代谢在中枢神经系统健康中的关键作用。我们这项工作的目的是就这一主题提供最新信息,重点是从内分泌学角度探讨临床实践。内分泌学家作为血脂异常管理方面的专家,通过早期且有效的血脂谱优化,在神经退行性疾病的预防和治疗中可发挥关键作用。

检索文献以确定关于血脂异常、他汀类药物治疗与以下神经退行性疾病之间关联的临床试验和相关性研究:阿尔茨海默病(AD)、帕金森病(PD)、多发性硬化症(MS)和肌萎缩侧索硬化症(ALS)。

脂质稳态受损,如在肥胖和糖尿病患者中经常观察到的情况,与神经退行性疾病有关,如AD、PD以及其他与衰老相关的认知缺陷。AD及相关痴呆症现在是一个真正的优先健康问题。在美国,约有700万65岁及以上的老年人患有AD及相关痴呆症,预计在未来几十年内这一数字将增至1200万。使用他汀类药物进行降脂治疗是将血清低密度脂蛋白胆固醇降至正常范围浓度从而降低心血管疾病风险的有效策略;此外,据报道他汀类药物对神经退行性疾病有积极作用。

我们的综述之后,几项研究发现了不一致的信息。他汀类药物的使用与ALS发病率之间没有关联。关于他汀类药物的使用与AD/PD之间出现了更多积极的证据。然而,需要进一步进行大规模前瞻性随机对照试验来正确理解这个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4f5/12029512/d8918db55d0e/metabolites-15-00282-g001.jpg

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