Managing diabetic dyslipidemia: beyond statin therapy.
Cardiovascular disease is a significant cause of morbidity and mortality in patients with diabetes mellitus. The lipid profile of type 2 diabetes mellitus is characterized by increased triglycerides (TGs), decreased high-density lipoprotein cholesterol (HDL-C), increased very low density lipoproteins (VLDLs), and small, dense low-density lipoprotein particles, the combination of which is highly atherogenic. In diabetic patients, current treatment guidelines target low-density lipoprotein cholesterol (LDL-C) <or= 100 mg/dL with statins. In patients with elevated TGs, non-HDL-C is considered a secondary target of therapy. Despite the use of statin therapy in diabetes, a significant number of fatal and nonfatal coronary heart disease (CHD) events still occur, indicating the need to target other modifiable risk factors for CHD, including high TGs and low HDL-C.
Neeli
Hemanth
H
Institute for Translational Medicine and Therapeutics, University of Pennsylvania School of Medicine, 654 BRB II/III, 421 Curie Boulevard, Philadelphia, PA 19104, USA. h.neeli77@yahoo.com
Gadi
Ram
R
Rader
Daniel J
DJ
D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D048909:Diabetes Complications / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D050171:Dyslipidemias / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015228:Hypertriglyceridemia / Q000097:blood; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood / Q000502:physiology; D008079:Lipoproteins, VLDL / Q000097:blood; D009525:Niacin / Q000627:therapeutic use; D047493:PPAR alpha / Q000819:agonists
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D008079:Lipoproteins, VLDL; D047493:PPAR alpha; D009525:Niacin