Die effektive Reduktion atherogener Lipoproteine hat dazu beigetragen, dass die Rate
an Arteriosklerose-bedingten kardiovaskulären Komplikationen in den letzten 50 Jahren
in etwa halbiert wurde. Dennoch werden in den nächsten Jahren kardiovaskuläre Erkrankungen
weltweit die häufigste Todesursache sein. Der Fokus dieser Übersicht liegt daher auf
der klinischen Bedeutung der Pathophysiologie von Veränderungen im Lipid- und Lipoproteinstoffwechsel.
Abstract
The effective reduction of atherogenic lipoproteins has contributed to the rate of
atherosclerosis-related cardiovascular complications being approximately halved over
the last 50 years. Nevertheless, cardiovascular disease will be the leading cause
of death worldwide in the coming years. The focus of this review is on the clinical
significance of the pathophysiology of changes in lipid and lipoprotein metabolism.
Elevated levels of atherogenic lipoproteins are a causal risk factor for atherosclerotic
cardiovascular disease. Primary forms of hypercholesterolaemia have a significantly
higher ASCVD risk because of the already lifelong LDL elevation (higher cumulative
LDL exposure for the vessel wall). Secondary changes in lipid and lipoprotein metabolism
(e. g. in diabetes or hypothyroidism) must be excluded or treated. Regulatory key
steps in the pathophysiology of lipid metabolism and atherosclerotic plaque are “drug
targets” for existing and new lipid and lipoprotein modifying therapies.
Schlüsselwörter
atherogene Lipoproteine - ASCVD-Risiko - regulative Schlüsselschritte - Diabetes mellitus
Key words
atherogenic lipoproteins - ASCVD risk - regulatory key steps - diabetes mellitus
