#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Lipid-lowering treatment in metabolic syndrome


Authors: T. Štulc;  R. Češka
Authors‘ workplace: Centrum preventivní kardiologie III. interní kliniky 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in: Vnitř Lék 2009; 55(7-8): 626-630
Category: 134th Internal Medicine Day - 23rd Vanysek's Day Brno 2009 - Vanysek's Lecture

Overview

During the last decades, metabolic syndrome has become an important healthcare problem worldwide. Main components of metabolic syndrome are insulin resistance (resulting often in impaired glucose tolerance and diabetes mellitus), dyslipidemia, hypertension and abdominal obesity. Incidence of metabolic syndrome is high and it substantially increases the risk of cardiovascular diseases. Dyslipidemia is a prominent factor contributing to the increased cardiovascular risk in metabolic syndrome, and lipid-lo­werign therapy plays an important role in treating patients with this disorder. Most patients with dyslipidemia are treated with statins and/or fibrates. Statins are used for treatment of hypercholesterolemia; fibrates are indicated for treatment of hypertriglyceridemia and/or low HDL‑cholesterol. In high risk patients with severe mixed hyperlipidemia, combination of statins with fibrates may be necessary to achieve the lipid goals.

Key words:
metabolic syndrome – dyslipidemia – cardiovascular risk – lipid-lowering drugs – statins – fibrates


Sources

1. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–1607.

2. Ford ES, Abbasi F, Reaven GM et al. Prevalence of insulin resistance and the metabolic syndrome with alternative definitions of impaired fasting glucose. Atherosclerosis 2005; 181: 143–148.

3. Lakka HM, Laaksonen DE, Lakka TA et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–2716.

4. Isomaa B, Almren P, Tuomi T et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–689.

5. Brunzell JD, Hokanson JE. Dyslipidemia of central obesity and insulin resistance. Diabetes Care 1999; 22 (Suppl 3): C10–C13.

6. Manninen V, Tenkanen L, Koskinen P et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment. Circulation 1992; 85: 37–45.

7. Cífková R, Škodová Z. Dlouhodobétrendy hlavních rizikových faktorů kar­diovaskulárních onemocnění v české populaci. Čas Lék Čes 2004; 143: 219–226.

8. Vaverková H, Soška V, Rosolová H et al. Doporučení pro diagnostiku a léčbu dyslipidemií v dospělosti, vypracované výborem České společnosti pro aterosklerózu. Vnitř Lék 2007; 53: 181–197.

9. Eilat-Adar S, Eldar M, Goldbourt U. Association of intentional changes in body weight with coronary heart disease event rates in overweight subjects who have an additional coronary risk factor. Am J Epidemiol 2005; 161: 352–358.

10. Cholesterol Treatment Triallists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta‑analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet 2005; 366: 1267–1278.

11. Collins R, Armitage J, Parish S et al. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 2003; 361: 2005–2016.

12. Colhoun HM, Betteridge DJ, Durrington PN et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 2004; 364: 685–696.

13. Birjmohun RS, Hutten BA, Kastelein JJ et al. Efficacy and safety of high‑density lipoprotein cholesterol-increasing compounds: a meta‑analysis of randomized controlled trials. J Am Coll Cardiol 2005; 45: 185–197.

14. Keech A, Simes RJ, Barter P et al. Effects of long‑term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet 2005; 366: 1849–1861.

15. Kamanna VS, Kashyap ML. Mechanism of action of niacin. Am J Cardiol 2008; 101: 20B–26B.

16. Drazen JM, D’Agostino RB, Ware JH et al. Ezetimibe and cancer – an uncertain association. N Engl J Med 2008; 359: 1398–1399.

17. Barter PJ, Caulfield M, Eriksson M et al. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med 2007; 357: 2109–2122.

Labels
Diabetology Endocrinology Internal medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#