Kaser Susanne, Dobrev Dobromir, Rocca Bianca, Kaski Juan Carlos, Agewall Stefan, Drexel Heinz
Department of Internal Medicine I, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, 45122 Essen, Germany.
Eur Heart J Cardiovasc Pharmacother. 2025 Jul 7;11(4):380-386. doi: 10.1093/ehjcvp/pvaf023.
Type 1 diabetes is associated with excess cardiovascular risk. In contrast to type 2 diabetes, however, age at the onset of type 1 diabetes and sex are major predictors of cardiovascular risk, while the role of low-density lipoprotein cholesterol (LDL-C) and lipid-lowering therapy is less clear. Since most data on the effects of lipid-lowering treatments are obtained from randomized clinical trials that included very predominantly patients with type 2 diabetes, it is almost impossible to specifically discern endpoints in type 1 diabetes. Inversely, most data specific for type 1 diabetes are obtained from real world findings. Consequently, the evidence on efficacy and safety of lipid-lowering therapies available from randomized clinical trials arises very predominantly from type 2 diabetes. Thus, this specific review summarizes the evidence of lipid-lowering drug classes in reducing cardiovascular risk in patients with type 1 diabetes.
1型糖尿病与心血管风险增加相关。然而,与2型糖尿病不同的是,1型糖尿病发病年龄和性别是心血管风险的主要预测因素,而低密度脂蛋白胆固醇(LDL-C)和降脂治疗的作用尚不清楚。由于大多数关于降脂治疗效果的数据来自随机临床试验,而这些试验主要纳入的是2型糖尿病患者,因此几乎不可能明确区分1型糖尿病患者的终点。相反,大多数针对1型糖尿病的特定数据来自真实世界的研究结果。因此,随机临床试验中关于降脂治疗有效性和安全性的证据主要来自2型糖尿病。因此,本综述专门总结了各类降脂药物在降低1型糖尿病患者心血管风险方面的证据。