Document Detail


Pharmacotherapy of mixed dyslipidemia in the metabolic syndrome.
MedLine Citation:
PMID:  20156152     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
People with metabolic syndrome (MetS) are at increased risk of type 2 diabetes and cardiovascular diseases, and often have increased triglyceride, reduced high-density lipoprotein cholesterol (HDL-C) and sometimes moderately increased low-density lipoprotein cholesterol (LDL-C) levels. Lifestyle intervention is critical for treating MetS, while pharmacotherapy of dyslipidemia in MetS remains controversial. Considering the specific lipid profile in MetS, fibrates are typically used as first-line treatment. Nevertheless, first-line therapy should be directed towards LDL-C, even in people with MetS, because of the evidence that lowering LDL-C has cardioprotective effects. Non-HDL-C is considered to be an alternative treatment target for people with moderately or severely elevated triglyceride (> or =200mg/dl). Statins improve lipid profiles principally by lowering LDL-C and may exert anti-inflammatory and anti-atherothrombogenic effects, which ameliorate the fundamental pathophysiology of MetS. Fibrates also have pleiotropic effects that improve cardiometabolic risk factors, including insulin resistance, although they do not have clear cardioprotective effects. Omega-3 fatty acids, niacin, pioglitazone and anti-obesity drugs are also candidates for the treatment of dyslipidemia and other complications in MetS. Another question is whether statins in combination with fibrates or other lipid-lowering drugs has greater cardioprotective properties than monotherapy. In this article, we discuss several issues in the pharmacotherapy of MetS.
Authors:
Kei Nakajima
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current clinical pharmacology     Volume:  5     ISSN:  1574-8847     ISO Abbreviation:  Curr Clin Pharmacol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-05     Completed Date:  2010-07-21     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101273158     Medline TA:  Curr Clin Pharmacol     Country:  United Arab Emirates    
Other Details:
Languages:  eng     Pagination:  133-9     Citation Subset:  IM    
Affiliation:
Division of Clinical Nutrition, Department of Medical Dietetics, Faculty of Pharmaceutical Sciences, Josai, University, 1-1 Keyakidai, Sakado, Saitama, Japan. keinaka@josai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / etiology,  prevention & control
Cholesterol, HDL / blood,  drug effects
Cholesterol, LDL / blood,  drug effects
Clofibric Acid / therapeutic use
Diabetes Mellitus, Type 2 / etiology,  prevention & control
Dyslipidemias / complications,  drug therapy*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Hypolipidemic Agents / therapeutic use*
Life Style
Metabolic Syndrome X / complications,  drug therapy*
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Hypolipidemic Agents; 882-09-7/Clofibric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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