Pathogenese und Bedeutung der diabetischen Dyslipidämie

Parhofer, K. G. und Wu, Liya (2019): Pathogenese und Bedeutung der diabetischen Dyslipidämie. In: Diabetologe, Bd. 15, Nr. 1: S. 7-12

Abstract

Diabetic dyslipidemia is characterized by elevated fasting and postprandial triglycerides, low high density lipoprotein (HDL) cholesterol, elevated low density lipoprotein (LDL) cholesterol and the predominance of small dense LDL particles. These lipid changes represent the major link between diabetes and the increased cardiovascular risk of diabetic patients. The underlying pathophysiology is only partially understood. Alterations of insulin sensitive pathways, increased concentrations of free fatty acids and low grade inflammation all play arole and result in an overproduction and decreased catabolism of triglyceride-rich lipoproteins of intestinal and hepatic origin. The observed changes in HDL and LDL are mostly aconsequence of this. The resulting increased concentration of apolipoproteinB containing particles is causally linked to the increased risk for atherosclerotic disease. Reducing LDL cholesterol levels below 70mg/dl (1.8mmol/l) or below 100mg/dl (2.6mmol/l)depending on the overall riskdecreases the cardiovascular risk and should be the primary prevention strategy. In patients with mixed dyslipidemia, achieving the target non-HDL cholesterol level, asurrogate for all apolipoproteinB containing particles, should be asecondary goal.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1860-9716
• Sprache: Deutsch