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1、ATPIII:ManagementofDiabeticDyslipidemiaPrimarytargetoftherapy:identificationofLDL-C;goalforpersonswithdiabetes:<100mg/dLTherapeuticoptions:LDL-C100–129mg/dL:increaseintensityofTLC;add drugtomodifyatherogenicdyslipidemia(fibrateor nicotinicacid);intensifyriskfactor
2、controlLDL-C?130mg/dL:simultaneouslyinitiateTLCand LDL-C–loweringdrugsTG?200mg/dL:non–HDL-C*becomessecondarytargetExpertPanelonDetection,Evaluation,andTreatmentof HighBloodCholesterolinAdults.JAMA.2001;285:2486-2497.Note:Diabeticdyslipidemiaisessentiallyatherogeni
3、cdyslipidemiainpersonswithtype2diabetes. *Non–HDL-Cgoalissetat30mg/dLhigherthanLDL-Cgoal.TM?2001,ProfessionalPostgraduateServices?www.lipidhealth.orgLIPID:ReductioninNonfatalMIand CHDDeathRiskStratifiedbyDiabeticStatus-19-25302520151050WithdiabetesWithoutdiabetes(
4、n=782)(n=8,232)LIPIDStudyGroup.NEnglJMed.1998;339:1349-1357.%TM?1999ProfessionalPostgraduateServices?TM?1999ProfessionalPostgraduateServices?BaselineAggressiveRxModerateRxPCharacteristic(N=1360)(N=1318)ValueCampeauetal.Circulation.1999;99:3241-3247.Post-CABG:Aggre
5、ssiveLDL-CLoweringDelaysProgressionofAtherosclerosisinWomen,Elderly,andPatientsWithSelectedCHDRiskFactorsn%n%Age(y):<6047930513400.0033608812780539<0.0001Female881563240.25 Male127229125540<0.0001Currentsmoker:Yes13732139500.01 No122327117938<0.0001Hypertension:Ye
6、s65527608390.0002No70528710390.0003Diabetesmellitus:Yes12227104430.04No123828121439<0.0001n=numberofgrafts.GraftsWithSubstantialProgressionTM?1999ProfessionalPostgraduateServices?0246MeanannualCHDmortalityrate/1,000AdaptedfromFontbonneAetal.Diabetologia.1989;32:30
7、0-304.Cholesterol(mg/dL)?220>220?220>220TG?123mg/dLTG?123mg/dLFastingTGandRiskforCHDDeath:ParisProspectiveStudyTM?1999ProfessionalPostgraduateServices?0123CHDmortality(per1,000)FontbonneAMetal.DiabetesCare.1991;14:461-469.?2930-5051-7273-114?115Quintiles(pmol)offa
8、stingplasmainsulinP<0.01CHDMortalityandHyperinsulinemia: ParisProspectiveStudy(n=943)TM?1999ProfessionalPostgraduateServices?010203040506012345%Macrovas
