Dyslipidemia in type 2 diabetes mellitus

Abstract

Type 2 diabetes mellitus is a chronic high-prevalence metabolic disease, which is characterized by hyperglycaemia, but also with lipid and protein metabolism disorders. Patients with type 2 diabetes have a high risk for cardiovascular disease (CVD) development and dyslipidemia is considered as a key marker of this increased risk. Hypertriglyceridemia, reduced high density lipoprotein cholesterol (HDL-c) concentrations, and a shift in low-density lipoprotein particles (LDL) distribution toward the small, triglycerides-rich particles, are the most important changes in the lipid profile in diabetes.Type 2 diabetes is a metabolic disorder associated with low grade inflammation and oxidative stress, so in this condition high density lipoprotein particles (HDL) also undergo structural and functional changes and, as a consequence, lose their atheroprotective role. Dyslipidemia treatment in type 2 diabetes patients younger than 40 and without any other risk factor for CVD development starts with changes in a lifestyle, but in patients older than 40 years, first line medications are statins.Glycemic and lipid control in type 2 diabetes patients significantly reduces CVD risk.

Dijabetes melitus tip 2 je hronično oboljenje sa visokom prevalencom, koje se karakteriše hiperglikemijom, ali i poremećajima u metabolizmu lipida i proteina. Pacijenti sa tipom 2 dijabetesa imaju visok rizik za razvoj kardiovaskularnih bolesti (KVB) i upravo se dislipidemija smatra ključnim uzročnikom ovog povećanog rizika. Hipertrigliceridemija, snižena koncentracija holesterola u lipoproteinskim česticama visoke gustine (HDL-h) i promena u raspodeli lipoproteinskih čestica niske gustine (LDL) u smeru većeg udela malih čestica, bogatih trigliceridima, predstavljaju najvažnije promene lipidnog profila koje se odnose na dislipidemiju u dijabetesu. Kako je dijabetes stanje kontinuirane blage inflamacije niskog stepena i stalne produkcije slobodnih radikala, HDL lipoproteinske čestice takođe podležu strukturnim i funkcionalnim promenama, usled čega gube svoje ateroprotektivne osobine. Terapija dislipidemije kod pacijenata mlađih od 40 godina bez prisutnih drugih faktora rizika za razvoj KVB počinje promenom životnog stila, a kod pacijenata starijih od 40 godina lekovi izbora u terapiji su statini. Glikemijska i lipidna kontrola kod pacijenata sa tipom 2 dijabetesa značajno umanjuje rizik od nastanka KVB.