High density lipoprotein: a therapeutic target in type 2 diabetes.
High density lipoprotein: a therapeutic target in type 2 diabetes.
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DOI：
10.3803/enm.2013.28.3.169
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Barter PJ
中科院分区：
文献类型：
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作者：
Barter PJ
高密度脂蛋白（hdl）有许多特性，有可能抑制动脉粥样硬化的发展，从而降低心血管事件的风险。高密度脂蛋白胆固醇的这些保护作用在2型糖尿病患者中可能会减弱，因为2型糖尿病患者的高密度脂蛋白胆固醇浓度通常较低。除了潜在的心脏保护特性外，hdl还可以增加骨骼肌对葡萄糖的摄取，刺激胰腺β细胞胰岛素的合成和分泌，因此可能对血糖控制有有益的作用。这就提出了2型糖尿病患者低HDL浓度可能导致糖尿病控制恶化的可能性。因此，针对2型糖尿病患者的高密度脂蛋白有双重目的：降低心血管风险，同时改善血糖控制。提高高密度脂蛋白水平的方法包括生活方式因素，如减肥、增加体育活动和戒烟。目前正在寻找提高高密度脂蛋白水平的药物，用于2型糖尿病患者，这些患者的高密度脂蛋白水平在生活方式干预后仍然很低。
High density lipoproteins (HDLs) have a number of properties that have the potential to inhibit the development of atherosclerosis and thus reduce the risk of having a cardiovascular event. These protective effects of HDLs may be reduced in patients with type 2 diabetes, a condition in which the concentration of HDL cholesterol is frequently low. In addition to their potential cardioprotective properties, HDLs also increase the uptake of glucose by skeletal muscle and stimulate the synthesis and secretion of insulin from pancreatic β cells and may thus have a beneficial effect on glycemic control. This raises the possibility that a low HDL concentration in type 2 diabetes may contribute to a worsening of diabetic control. Thus, there is a double case for targeting HDLs in patients with type 2 diabetes: to reduce cardiovascular risk and also to improve glycemic control. Approaches to raising HDL levels include lifestyle factors such as weight reduction, increased physical activity and stopping smoking. There is an ongoing search for HDL-raising drugs as agents to use in patients with type 2 diabetes in whom the HDL level remains low despite lifestyle interventions.