Fettstoffwechsel: Diagnostik und Therapie

Fettstoffwechselstörungen sind sowohl in der allgemeinen Bevölkerung als auch bei Patienten mit Diabetes mellitus häufig. Ihre Therapie leistet einen wichtigen Beitrag bei der primären und sekundären Prävention kardiovaskulärer Erkrankungen. Dieser Beitrag fasst den aktuellen Stand von pathophysiologischen, diagnostischen und therapeutischen Aspekten von Fettstoffwechselstörungen unter dem Gesichtspunkt der kardiovaskulären Prävention zusammen.

Abstract

Lipid disorders are common both in the general population and in patients with diabetes mellitus. The therapy makes an important contribution to the primary and secondary prevention of cardiovascular disease. In patients without diabetes, the focus is on LDL cholesterol. In patients with diabetes, non-HDL cholesterol and elevated triglycerides deserve special attention. In some cases, extremely high triglycerides can result in acute pancreatitis. This article summarizes the current status of the pathophysiological, diagnostic and therapeutic aspects of lipid disorders from the point of view of cardiovascular prevention.

Kernaussagen

• Die cholesterinsenkende Therapie ist ein wichtiger Baustein der kardiovaskulären Prävention.

• Die lipidologische Prävention erfolgt risikoadaptiert als zielwertgerechte Stufentherapie.

• Neben Lebensstilmaßnahmen ist die Gabe von Statinen die zentrale Maßnahme.

• Weitere Therapeutika sind Ezetimib, Bempedoinsäure und Inhibitoren von PCSK9.

• Ultima Ratio ist die Lipidapherese.

• Derzeit wird ein Großteil der Patienten nicht zielwertgerecht therapiert.

Schlüsselwörter

LDL-Cholesterin - kardiovaskuläres Risiko - Lipidtherapie - Prävention

Keywords

LDL cholesterol - cardiovascular risk - lipid therapy - prevention

Publication History

Article published online:
21 February 2022

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