Common medications used by patients with type 2 diabetes mellitus: what are their effects on the lipid profile?

Cardiovascular Diabetology

Review

Paul D. Rosenblit¹ 

[1] Diabetes/Lipid Management & Research Center, 18821 Delaware St, Suite 202, 92648, Huntington Beach, CA, USA;Division of Endocrinology, Diabetes, Metabolism, Department of Medicine, University of California, Irvine (UCI) School of Medicine, Irvine, CA, USA;

关键词: Atherosclerosis;    Dyslipidemia;    HDL cholesterol;    LDL cholesterol;    Triglycerides;    Type 2 diabetes mellitus;    Cardiovascular risk factors;    Polypharmacy;   

DOI  :  10.1186/s12933-016-0412-7

 received in 2016-03-17, accepted in 2016-06-14,  发布年份 2016

来源: Springer

【 摘 要 】

Dyslipidemia is the most fundamental risk factor for atherosclerotic cardiovascular disease (ASCVD). In clinical practice, many commonly prescribed medications can alter the patient’s lipid profile and, potentially, the risk for ASCVD—either favorably or unfavorably. The dyslipidemia observed in type 2 diabetes mellitus (T2DM) can be characterized as both ominous and cryptic, in terms of unrecognized, disproportionately elevated atherogenic cholesterol particle concentrations, in spite of deceptively and relatively lower levels of low-density lipoprotein cholesterol (LDL-C). Several factors, most notably insulin resistance, associated with the unfavorable discordance of elevated triglyceride (TG) levels and low levels of high-density lipoprotein cholesterol (HDL-C), have been shown to correlate with an increased risk/number of ASCVD events in patients with T2DM. This review focuses on known changes in the routine lipid profile (LDL-C, TGs, and HDL-C) observed with commonly prescribed medications for patients with T2DM, including antihyperglycemic agents, antihypertensive agents, weight loss medications, antibiotics, analgesics, oral contraceptives, and hormone replacement therapies. Given that the risk of ASCVD is already elevated for patients with T2DM, the use of polypharmacy may warrant close observation of overall alterations through ongoing lipid-panel monitoring. Ultimately, the goal is to reduce levels of atherogenic cholesterol particles and thus the patient’s absolute risk.

【 授权许可】

CC BY   
© The Author(s) 2016