Fettstoffwechselstörungen und Glaukom

Zusammenfassung

In der multifaktoriellen Pathogenese der glaukomatösen Optikusatrophie spielen endotheliale Dysfunktion und vaskuläre Dysregulation eine Rolle. Dyslipidämie als Risikofaktor für die endotheliale Dysfunktion ist sowohl mit der Glaukomerkrankung als auch mit kardiovaskulärer Morbidität und Mortalität assoziiert. Ein möglicher Mechanismus ist bei gegebener genetischer Disposition die additive Wirkung verschiedener Risikofaktoren für die endotheliale Dysfunktion, wie Dyslipidämie, Rauchen, arterielle Hypertonie, Diabetes und Hyperhomozysteinämie. In dieser Übersichtsarbeit wird die aktuelle Datenlage zur Assoziation zwischen Dyslipidämie und Glaukomerkrankung dargelegt sowie eine mögliche Rolle der Dyslipidämie in der Pathogenese und Progression der Glaukomerkrankung erläutert. Die Bedeutung exogener modifizierbarer Risikofaktoren für die Prävention und Therapie der Glaukomerkrankung sowie ihrer Neutralisierung durch eine Änderung des Lebensstils, wie Gewichtsreduktion, Modifizierungen der Ernährung und gesteigerte körperliche Aktivität, wird diskutiert.

Abstract

Endothelial dysfunction and vascular dysregulation play a role in the multifactorial pathogenesis of glaucomatous optic nerve atrophy. Dyslipidaemia as a risk factor for endothelial dysfunction is associated with glaucoma and cardiovascular morbidity and mortality. In additional to a genetic disposition, a potential mechanism for the pathogenesis of endothelial dysfunction could be an additive effect of several risk factors, like dyslipidaemia, smoking, arterial hypertension, diabetes and hyperhomocysteinaemia. This paper reviews the literature concerning the association between dyslipidaemia and glaucomatous disease and explains the possible role of dyslipidaemia for the pathogenesis and progression of glaucoma. The role of exogeneous modifiable risk factors for prevention and therapy of glaucoma and their neutralisation by changing life style like weight reduction, modifications of nutrition and physical activity, are discussed.

Schlüsselwörter

Glaukom - Lipide - Dyslipidämie - oxidativer Stress - endotheliale Dysfunktion - Homozystein

Key words

glaucoma - lipids - dyslipidaemia - oxidative stress - endothelial dysfunction - homocysteine

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