Dyslipidaemia in Type 1 Diabetes: Molecular Mechanisms and Therapeutic Opportunities

被引:6
|
作者
O'Brien, Stephen T. [1 ]
Neylon, Orla M. [1 ]
O'Brien, Timothy [2 ]
机构
[1] Univ Hosp Limerick, Dept Paediat, Limerick V94 F858, Ireland
[2] Natl Univ Ireland, Sch Med, Dept Med, Galway H91 TK33, Ireland
关键词
Type 1 diabetes mellitus; dyslipid(a)emia; atherosclerosis; LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY CALCIFICATION; CARDIOVASCULAR RISK-FACTORS; IMMUNE-COMPLEXES; YOUNG-ADULTS; FAMILIAL HYPERCHOLESTEROLEMIA; ENDOTHELIAL FUNCTION; EXCESS MORTALITY; STATIN THERAPY; LIPID PROFILE;
D O I
10.3390/biomedicines9070826
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Cardiovascular disease (CVD) is the leading cause of death in Type 1 Diabetes (T1D). The molecular basis for atherosclerosis in T1D is heavily influenced by hyperglycaemia and its atherogenic effects on LDL. Ongoing research into the distinct pathophysiology of atherosclerosis in T1D offers exciting opportunities for novel approaches to calculate CVD risk in patients with T1D and to manage this risk appropriately. Currently, despite the increased risk of CVD in the T1D population, there are few tools available for estimating the risk of CVD in younger patients. This poses significant challenges for clinicians in selecting which patients might benefit from lipid-lowering therapies over the long term. The current best practice guidance for the management of dyslipidaemia in T1D is generally based on evidence from patients with T2D and the opinion of experts in the field. In this review article, we explore the unique pathophysiology of atherosclerosis in T1D, with a specific focus on hyperglycaemia-induced damage and atherogenic LDL modifications. We also discuss the current clinical situation of managing these patients across paediatric and adult populations, focusing on the difficulties posed by a lack of strong evidence and various barriers to treatment.
引用
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页数:17
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