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The Atherogenic Dyslipidemia Complex and Novel Approaches to Cardiovascular Disease Prevention in Diabetes
- Source :
- Canadian Journal of Cardiology. 34:595-604
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Despite the effectiveness of low-density lipoprotein (LDL)-lowering strategies for the treatment of diabetic dyslipidemia, significant residual risk of atherosclerotic cardiovascular disease remains. Residual risk might in part be explained by lipid abnormalities that go beyond LDL cholesterol elevation, collectively termed the "atherogenic dyslipidemia complex (ADC)," consisting of hypertriglyceridemia, elevated small dense LDL particles, reduced high-density lipoprotein cholesterol, and high-density lipoprotein particle numbers, increased remnant lipoproteins, and postprandial hyperlipidemia. In this review, we briefly discuss the pathophysiology of the typical dyslipidemia that occurs in insulin-resistant states including obesity, the metabolic syndrome, and type 2 diabetes. Lipid-modifying strategies including lifestyle modification, ezetimibe, statins, fibrates, niacin, and cholesteryl ester transfer protein inhibitors in treating ADC are discussed. With the advent of novel therapies involving antisense oligonucleotides and monoclonal antibodies, new targets can be specifically downregulated to potentially promote lipoprotein clearance or suppress production. We review novel approaches currently undergoing clinical testing and we speculate on their suitability for use in treating ADC for the prevention of atherosclerotic cardiovascular disease. In addition, future targets that might be considered for therapeutic development are discussed.
- Subjects :
- 030204 cardiovascular system & hematology
Bioinformatics
Lipoprotein particle
03 medical and health sciences
0302 clinical medicine
Drug Development
Ezetimibe
Cholesterylester transfer protein
Hyperlipidemia
Humans
Medicine
030212 general & internal medicine
Dyslipidemias
biology
business.industry
Hypertriglyceridemia
Atherosclerosis
medicine.disease
Patient Care Management
Diabetes Mellitus, Type 2
Cardiovascular Diseases
biology.protein
lipids (amino acids, peptides, and proteins)
Insulin Resistance
Cardiology and Cardiovascular Medicine
business
Dyslipidemia
Niacin
Lipoprotein
medicine.drug
Subjects
Details
- ISSN :
- 0828282X
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Canadian Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....cd593e50ddd873e156b40ae5f20b0a65