Lipoprotein alterations and atherosclerosis in the elderly.
Lipoprotein alterations and atherosclerosis in the elderly.
复制标题
老年人的脂蛋白改变和动脉粥样硬化。
DOI：
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复制
发表时间：
1997
影响因子：
4.4
通讯作者：
G. Baggio
中科院分区：
文献类型：
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作者：
M. Corti;G. Barbato;G. Baggio
脂蛋白在动脉粥样硬化性疾病的发病机制中起关键作用。随着年龄的增长，脂蛋白脂的代谢、分布和相关因素的改变已经被描述。与年龄相关的脂蛋白变化是由几个遗传和环境因素决定的，但在老年人中，存在合并症和健康状况不佳也起着重要作用。在老年人群中，脂蛋白水平预测心血管风险的能力是有争议的。当在老年时测量脂蛋白水平时，总脂蛋白和高密度脂蛋白-胆固醇水平的继发性变化可能导致错误分类和低估相关性。因此，在分析老年人群的相关性时，重要的是要考虑疾病负担和合并症的措施。当考虑到这些警告时，来自老年人观察性研究的证据证实了脂蛋白脂与心脑血管疾病之间的关联。在老年心血管疾病患者中，干预试验表明降脂药物可显著降低总死亡率和冠心病死亡率。目前仍缺乏明确的证据表明降脂药物对没有心血管疾病的老年人和非常老年人有益。需要对老年男性和女性进行初级和二级干预试验的结果来提供结论性指导。
Lipoproteins play a key role in the pathogenesis of atherosclerotic diseases. With increasing age, modifications in the metabolism, distribution and correlates of lipoprotein lipids have been described. Age associated changes in lipoproteins are determined by several genetic and environmental factors, but in elderly populations, an important role is also played by the presence of comorbid diseases and poor health. In older populations, the ability of lipoprotein levels to predict cardiovascular risk is controversial. When lipoprotein levels are measured at old age, secondary changes in total and high density lipoprotein-cholesterol levels may lead to misclassification and to underestimation of associations. When analyzing associations in older populations, it is therefore important to consider measures of disease burden and comorbidity. When these caveats are taken into account, evidence from observational studies in older persons confirms the association between lipoprotein lipids, cardiovascular and cerebrovascular disease. Among older patients with cardiovascular disease, intervention trials have demonstrated that lipid lowering drugs can significantly reduce total and coronary heart disease mortality. Unequivocal evidence that lipid-lowering drugs are beneficial in old and very old persons without pre-existing cardiovascular disease is still lacking. Results from primary and secondary intervention trials in older men and women are needed to provide conclusive guidelines.