diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM10351diaendo-10351Research ArticleОбзорыReviewХолестерин, не связанный с липопротеинами высокой плотности, и сердечно-сосудистые заболевания у пациентов с сахарным диабетом и дислипидемиейNon- high-density lipoprotein cholesterol and cardiovascular disease in patients with diabetic dyslipidaemiahttps://orcid.org/0000-0001-7096-5201ZambonAlberto

Department of Medicine - DIMED, MD, PhD, Professor

alberto.zambon@unipd.itУниверситет ПадуяИталияUniversity of PadovaItaly2020210420202316571Copyright © Zambon A., 20202020Zambon A.Zambon A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/10351

Повышенный уровень липидов в крови является одним из основных факторов риска развития сердечно-сосудистых заболеваний (ССЗ) у пациентов с сахарным диабетом 2 типа (СД2). Дислипидемия на фоне СД характеризуется наличием потенциально атерогенных липидов, включая высокие уровни триглицеридов (ТГ) в плазме, умеренно повышенным уровнем холестерина липопротеинов низкой плотности (ХС ЛПНП) и низким уровнем холестерина липопротеинов высокой плотности (ХС ЛПВП). Терапия статинами, направленная на снижение уровня ХС ЛПНП, является основным методом лечения с целью снижения риска развития ССЗ, обусловленных атеросклерозом. Однако, несмотря на достижение целевых уровней ХС ЛПНП, у пациентов с дислипидемией на фоне СД сохраняется высокий риск развития остаточных нежелательных явлений, связанных с заболеваниями сердечно-сосудистой системы. Следовательно, существует необходимость обращать внимание на другие компоненты (например, повышенные уровни ТГ) атерогенной дислипидемии, на которые не влияет терапия статинами. В этом обзоре подчеркнуты клинические преимущества использования уровня ХС не-ЛПВП как единственного маркера, который включает все атерогенные липопротеины, в качестве основной цели терапии, направленной на снижение риска развития остаточных явлений, связанных с заболеваниями сердечно-сосудистой системы.

Elevated levels of blood lipids are one of the major risk factors for cardiovascular (CV) disease in patients with type 2 diabetes mellitus. Diabetic dyslipidaemia is characterised by the presence of potentially atherogenic lipids, including high levels of plasma triglycerides (TGs), mild-to-moderately elevated levels of low-density lipoprotein cholesterol (LDL-C), and low levels of high-density lipoprotein cholesterol (HDL-C). Statin therapy to reduce LDL-C levels is the mainstay of treatment practice to reduce CV risk. However, despite achieving targets for LDL-C, patients with diabetic dyslipidaemia remain at a high risk of residual CV events. Hence there is a need to target other components (i.e. elevated TGs) of the atherogenic dyslipidaemia that are not affected by treatment with statins. This review highlights the clinical benefits of using non-HDL-C, a single marker that includes all atherogenic lipoproteins, as a leading treatment target to reduce the residual CV risk.

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The authors declare that there are no conflicts of interest present.