Dyslipidämie bei Diabetes

Das erhöhte kardiovaskuläre Risiko bei Patienten mit Diabetes entsteht wesentlich durch die diabetische Dyslipidämie. In vielen Fällen ist diese zielwertgerecht therapierbar, sodass im Optimalfall das kardiovaskuläre Risiko allein hierdurch deutlich reduziert werden kann. Der Fokus dieses Beitrags liegt auf Pathogenese, Diagnostik und Therapiebesonderheiten der Fettstoffwechselstörungen bei Diabetes mellitus Typ 2.

Abstract

Diabetic dyslipidemia is a major cause of the increased cardiovascular risk in diabetes. This lipid disorder is characterized by increased plasma triglycerides, increased remnant particles of triglyceride-rich lipoproteins, small dense LDL particles and reduced HDL cholesterol. The main pathogenetic triggers are obesity and insulin resistance. In addition to lifestyle measures, statins, ezetimibe and eventually PCSK9 inhibitors are available to treat diabetic dyslipidemia and to reduce the cardiovascular risk. Fibrates and omega-3 fatty acids currently do not play a significant therapeutic role. A consistent and target-oriented therapy of diabetic dyslipidemia is a prerequisite for a cardiovascular risk reduction in patients with diabetes, which has been well proven in clinical studies.

Schlüsselwörter

Dyslipidämie - Diabetes - Triglyzeride - Lipidtherapie - kardiovaskuläres Risiko

Key words

dyslipidemia - diabetes - triglycerides - lipid therapy - cardiovascular risk

Publication History

Article published online:
19 January 2021

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