Common medications used by patients with type 2 diabetes mellitus: what are their effects on the lipid profile?

被引:50
|
作者
Rosenblit, Paul D. [1 ,2 ]
机构
[1] Diabet Lipid Management & Res Ctr, 18821 Delaware St,Suite 202, Huntington Beach, CA 92648 USA
[2] Univ Calif Irvine, Sch Med, Dept Med, Div Endocrinol,Diabet,Metab, Irvine, CA 92717 USA
关键词
Atherosclerosis; Dyslipidemia; HDL cholesterol; LDL cholesterol; Triglycerides; Type 2 diabetes mellitus; Cardiovascular risk factors; Polypharmacy; CORONARY-HEART-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; CONTROLLED-RELEASE PHENTERMINE/TOPIRAMATE; POSTPRANDIAL ENDOTHELIAL DYSFUNCTION; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; ALPHA-GLUCOSIDASE INHIBITORS; INCRETIN-BASED THERAPIES; ESTROGEN PLUS PROGESTIN; CARDIOVASCULAR-DISEASE; GLYCEMIC CONTROL;
D O I
10.1186/s12933-016-0412-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Dyslipidemia is the most fundamental risk factor for atherosclerotic cardiovascular disease (ASCVD). In clinical practice, many commonly prescribed medications can alter the patient's lipid profile and, potentially, the risk for ASCVD-either favorably or unfavorably. The dyslipidemia observed in type 2 diabetes mellitus (T2DM) can be characterized as both ominous and cryptic, in terms of unrecognized, disproportionately elevated atherogenic cholesterol particle concentrations, in spite of deceptively and relatively lower levels of low-density lipoprotein cholesterol (LDL-C). Several factors, most notably insulin resistance, associated with the unfavorable discordance of elevated triglyceride (TG) levels and low levels of high-density lipoprotein cholesterol (HDL-C), have been shown to correlate with an increased risk/number of ASCVD events in patients with T2DM. This review focuses on known changes in the routine lipid profile (LDL-C, TGs, and HDL-C) observed with commonly prescribed medications for patients with T2DM, including anti-hyperglycemic agents, antihypertensive agents, weight loss medications, antibiotics, analgesics, oral contraceptives, and hormone replacement therapies. Given that the risk of ASCVD is already elevated for patients with T2DM, the use of polypharmacy may warrant close observation of overall alterations through ongoing lipid-panel monitoring. Ultimately, the goal is to reduce levels of atherogenic cholesterol particles and thus the patient's absolute risk.
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页数:13
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