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WCC 2014：总胆固醇和LDL-C水平升高可导致慢性肾病风险增加

2014-07-28 MedSci MedSci原创

LDL胆固醇慢性肾病
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世界心脏联合会主办的2014年世界心脏病学大会上公布的一项回顾性分析显示，总胆固醇和低密度脂蛋白胆固醇水平升高与冠心病患者的慢性肾病风险增加显著相关。 这项分析由加州大学旧金山分校的医学教授Prakash Deedwania医生及其同事进行，所分析的数据来自两项大型、随机、对照试验（TNT和IDEAL），共涉及超过19,000例接受阿托伐他汀或辛伐他汀治疗的冠心病患者，研究者在这些患者

低密度脂蛋白(LDL)通过载脂蛋白B(Apo-B)与内膜下细胞的B受体结合，将胆固醇从肝细胞运往组织细胞。低密度脂蛋白胆固醇可通俗地理解为"坏"胆固醇，因为LDL-C水平升高会增加患冠状动脉心脏病的危险性。LDL-C 升高是肾病综合征的特点，但并非进展期CKD 和血透患者的典型特点。

大约60%慢性肾脏疾病患者会出现血脂异常的现象,既往也研究表明在冠心病和慢性肾脏疾病患者中,他汀类药物具有改善肾功能的效应。然而并没有研究探讨过基线脂质参数对肾功能的影响。

在今年的世界心脏病学大会（WCC）上，来自加州大学旧金山分校的Prakash Deedwania教授与他的团队，公布的一项试验结果，结果显示：总胆固醇>240 mg /dL的，慢性肾脏疾病的风险会增加78%，低密度脂蛋白胆固醇（LDL)）水平>190 mg/dL，则风险增加72%。

这项回顾性分析所采用的数据来自两项大型随机对照试验（TNT和IDEAL），共涉及超过19,000例接受阿托伐他汀或辛伐他汀治疗的冠心病患者。


Deedwania医生表示，该研究表明总胆固醇和LDL-C水平与慢性肾功能之间存在非常密切的关联。同时他还指出，治疗的关键在于早期干预治疗。另外，他建议那些在干预试验中没能观察到治疗效果的，应选择早期患者。研究者声明从药企获得演讲费、顾问费和酬金。其中两名研究者为辉瑞公司员工。

相关论文：

Pedersen TR1, Faergeman O, Kastelein JJ, Olsson AG, Tikkanen MJ, Holme I, Larsen ML, Bendiksen FS, Lindahl C, Szarek M, Tsai J; Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) Study Group.High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial.JAMA. 2005 Nov 16;294(19):2437-45.

LaRosa JC1, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC, Gotto AM, Greten H, Kastelein JJ, Shepherd J, Wenger NK; Treating to New Targets (TNT) Investigators.Intensive lipid lowering with atorvastatin in patients with stable coronary disease.N Engl J Med. 2005 Apr 7;352(14):1425-35. Epub 2005 Mar 8.

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    2015-08-04 sundong

    高脂可导致肾病

    0

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    2015-02-17 ycmayy

    #总胆固醇#

    0

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    2015-03-11 ms3153534357578991

    #WCC#

    0

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    2014-07-30 zhwj

    #LDL#

    0

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