新型非他汀疗法对心血管糖尿病的系统性影响:以 PCSK9 为例

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular Endocrinology & Metabolism Pub Date : 2020-05-05 eCollection Date: 2020-12-01 DOI:10.1097/XCE.0000000000000204
Mouhamed Nashawi, Omar Sheikh, Mahnoor Mir, Tri Te, Robert Chilton
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引用次数: 0

摘要

PCSK9 和其他新型非他汀类药物一样,主要是为了帮助患者达到低密度脂蛋白胆固醇目标而开发的,尤其适用于因耐受性差或反应不充分而无法通过他汀类药物达到血脂目标的血脂异常患者。PCSK9 抑制剂除了能调节血脂代谢外,还能改善心血管疾病的死亡率。这些益处在 2 型糖尿病患者中尤为明显。然而,这些益处并非没有相关风险。多项试验、研究和病例报告都试图从多个角度解释 PCSK9 表达和服用 PCSK9 抑制剂后观察到的结果,例如它们对胰岛素敏感性和葡萄糖耐量的影响、肾脏生理变化、甲状腺生理变化、血管张力、肠道对血脂的调节以及心血管功能的改善。这些药物为医生提供了一个机会,在管理高血糖患者的并发症时,可通过适当的临床判断谨慎行事,这一理念也适用于其他新型非他汀类药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The systemic implication of novel non-statin therapies in cardiovascular diabetology: PCSK9 as a case model.

PCSK9, like other novel non-statin drugs were primarily developed to help patients achieve low-density lipoprotein cholesterol targets, especially in patients with dyslipidemia not achieving lipid goals with statins due to poor tolerance or inadequate response. PCSK9 inhibitors, in addition to modulating lipid metabolism, improve mortality outcomes in cardiovascular disease. These benefits are markedly pronounced in patients with type 2 diabetes mellitus. However, these benefits do not come without associated risk. Multiple trials, studies, and case reports have attempted to explain observed outcomes with PCSK9 expression and administration of PCSK9 inhibitors from multiple perspectives, such as their effects on insulin sensitivity and glucose tolerance, changes in renal physiology, thyroid physiology, vascular tone, intestinal regulation of lipids, and improved cardiovascular function. These agents represent an opportunity for physicians to exercise prudence by using appropriate clinical judgement when managing comorbidities in the hyperglycemic patient, a concept that extends to other novel non-statin drugs.

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来源期刊
Cardiovascular Endocrinology & Metabolism
Cardiovascular Endocrinology & Metabolism CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.60
自引率
0.00%
发文量
24
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