High-Density Lipoprotein

Mortensen, Stefan P.; Boushel, Robert

doi:10.1161/circulationaha.113.006345

Cited by 9 publications

(2 citation statements)

References 13 publications

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“…Proposed mechanisms include anti-inflammatory properties of HDL-cholesterol and the central role of HDL-cholesterol in mediating reverse cholesterol transport, or cholesterol efflux, which may subsequently improve insulin sensitivity and/or secretion. 107,121,122 Recent investigations suggest a role for impaired HDL function, with decreased cholesterol efflux capacity in diabetes. 123 However, to date pharmacologic means to raise HDL cholesterol levels have not been associated with both glucose lowering and improved cardiovascular outcomes, as discussed below in the section on non-statin lipid lowering trials.…”

Section: Mechanisms Of Increased Ascvd Risk and Mortality In Type 2 Dmentioning

confidence: 99%

Clinical Update: Cardiovascular Disease in Diabetes Mellitus

et al. 2016

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Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multi-factorial risk reduction with statins and other lipid lowering agents, anti-hypertensive therapies, and anti-hyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes than for those without. This review considers the mechanisms, history, controversies, new pharmacologic agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes and heart disease outside of the acute care setting.

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Section: Mechanisms Of Increased Ascvd Risk and Mortality In Type 2 Dmentioning

confidence: 99%

Clinical Update: Cardiovascular Disease in Diabetes Mellitus

et al. 2016

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“…Since then a number of studies have tried to shed light on the underlying pathophysiology and several mechanisms were identified ( Fig. 1 ) [ 21 22 ]. HDL induce reverse cholesterol transport and the altered intracellular lipid environment is believed to reduce micro-inflammation.…”

Section: Lipid Changes Causing Type 2 Diabetesmentioning

confidence: 99%

Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia

2015

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Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoAreductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dosedependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

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Klinische Bedeutung des HDL-Cholesterins

März

Kleber

Scharnagl

et al. 2016

Herz

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Compared with low-density lipoprotein cholesterol (LDL-C), HDL‑C is of secondary importance for cardiovascular risk stratification and the calculation of the LDL-C:HDL‑C ratio is not useful for all patients. Low HDL‑C levels should prompt a search for additional metabolic and inflammatory pathologies. An increase in HDL‑C through lifestyle changes (e.g. smoking cessation and physical exercise) has positive effects and is recommended; however, HDL‑C is currently not a valid target for drug therapy.

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High-Density Lipoprotein

Cited by 9 publications

References 13 publications

Clinical Update: Cardiovascular Disease in Diabetes Mellitus

Clinical Update: Cardiovascular Disease in Diabetes Mellitus

Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia

Klinische Bedeutung des HDL-Cholesterins

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