Diabetes: mellitus or lipidus?

Shafrir, Eleazar; Raz, Itamar

doi:10.1007/s00125-003-1052-5

Cited by 69 publications

(35 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since evidence indicates that multiple aberrations in lipids metabolism play a pivotal role in the pathophysiology of diabetes, it was suggested to drop the adjective "mellitus" from diabetes and then to consider the introduction of a new adjective "lipidus" or "lipomellitus" [114] (Figure 1). …”

Section: Hypertriglyceridemia As a Major Component Of Atherogenic Dysmentioning

confidence: 99%

Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor

Tenenbaum

Klempfner

Fisman

2014

Cardiovasc Diabetol

View full text Add to dashboard Cite

The existence of an independent association between elevated triglyceride (TG) levels, cardiovascular (CV) risk and mortality has been largely controversial. The main difficulty in isolating the effect of hypertriglyceridemia on CV risk is the fact that elevated triglyceride levels are commonly associated with concomitant changes in high density lipoprotein (HDL), low density lipoprotein (LDL) and other lipoproteins. As a result of this problem and in disregard of the real biological role of TG, its significance as a plausible therapeutic target was unfoundedly underestimated for many years. However, taking epidemiological data together, both moderate and severe hypertriglyceridaemia are associated with a substantially increased long term total mortality and CV risk. Plasma TG levels partially reflect the concentration of the triglyceride-carrying lipoproteins (TRL): very low density lipoprotein (VLDL), chylomicrons and their remnants. Furthermore, hypertriglyceridemia commonly leads to reduction in HDL and increase in atherogenic small dense LDL levels. TG may also stimulate atherogenesis by mechanisms, such excessive free fatty acids (FFA) release, production of proinflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia and high concentrations of TRL as causal risk factors for CV disease. The most common forms of hypertriglyceridemia are related to overweight and sedentary life style, which in turn lead to insulin resistance, metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM). Intensive lifestyle therapy is the main initial treatment of hypertriglyceridemia. Statins are a cornerstone of the modern lipids-modifying therapy. If the primary goal is to lower TG levels, fibrates (bezafibrate and fenofibrate for monotherapy, and in combination with statin; gemfibrozil only for monotherapy) could be the preferable drugs. Also ezetimibe has mild positive effects in lowering TG. Initial experience with en ezetimibe/fibrates combination seems promising. The recently released IMPROVE-IT Trial is the first to prove that adding a non-statin drug (ezetimibe) to a statin lowers the risk of future CV events. In conclusion, the classical clinical paradigm of lipids-modifying treatment should be changed and high TG should be recognized as an important target for therapy in their own right. Hypertriglyceridemia should be treated.

show abstract

Section: Hypertriglyceridemia As a Major Component Of Atherogenic Dysmentioning

confidence: 99%

Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor

Tenenbaum

Klempfner

Fisman

2014

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…They demonstrated that non-suppression of free fatty acids occurred as the blood sugars rose even in the normoglycaemic range. In a thought provoking review many years later Shafrir and Raz [25] made the suggestion and gave strong evidence to support the suggestion that Diabetes Mellitus should be renamed "Diabetes Lipidus". Poorly controlled diabetes is usually associated with hypertriglyceridaemia which very often responds to hypoglycaemic therapy and normalization of blood sugars.…”

Section: Atherosclerosis In Diabetesmentioning

confidence: 99%

Disturbed Chylomicron Metabolism in Type 2 Diabetes - A Preventable Cause of Atherosclerosis?

Tomkin¹,

Owens²

2011

Role of the Adipocyte in Development of Type 2 Diabetes

View full text Add to dashboard Cite

“…The semantic question posed by Sharir and Raz [1], requires a final comment. It is very difficult to change an established name of a prevalent disease, a name that has been with us for a long time.…”

Section: Author's Replymentioning

confidence: 99%

“…Shafrir and Raz bring up an interesting semantic question in a recent issue of Diabetologia [1]. Should diabetes mellitus be called diabetes lipidus because the basic metabolic aberration actually starts in lipid rather than in carbohydrate metabolism?…”

mentioning

confidence: 99%

?to: Shafrir E, Raz I (2003) For Debate. Diabetes: mellitus or lipidus? Diabetologia 46: 433?440

Björntorp

2003

Diabetologia

View full text Add to dashboard Cite

Diabetes: mellitus or lipidus?

Cited by 69 publications

References 102 publications

Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor

Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor

Disturbed Chylomicron Metabolism in Type 2 Diabetes - A Preventable Cause of Atherosclerosis?

?to: Shafrir E, Raz I (2003) For Debate. Diabetes: mellitus or lipidus? Diabetologia 46: 433?440

Contact Info

Product

Resources

About