Non-HDL-C:血脂干预管理的新靶标

Non-HDL-C:new target for dyslipidemia management

LDL-C被认为是启动及调整降脂治疗的首要目标,如果仅考虑LDL-C水平,可能低估心血管疾病危险。即使强化他汀治疗,仍然存在剩留心血管病风险。非高密度脂蛋白胆固醇(non-HDL-C)是体内总胆固醇减去HDL-C后的剩余部分,能更全面反映包括LDL、IDL及VLDL等"坏血脂"的代谢变化。众多循证医学证据显示,non-HDL-C不仅更有助于预测心血管事件的发生,而且还是更恰当的他汀类药物治疗目标。

Summary LDL C is considered the primary target for start up and adjustment of lipid-lowering therapy. However, only taking the LDL C into account, we could underestimate the risk of cardiovascular disease. Mean- while, the residual risk cardiovascular disease could not be eliminated in the patients undergoing intensive statin therapy. Therefore, the new lipid parameters as the substitute for LDL-C will contribute to guide the lipid-lower- ing therapy. Non-HDL cholesterol is the total cholesterol minus the HDL-C, and reflects the metabolism o{ the bad cholesterol （including LDL, IDL and VLDL）. Many studies have demonstrated that non-HDL predict the car- diovascular disease even better than LDL-C. Therefore, guidelines for the management of dyslipidaemia are also gradually increasing its recommended level. However, the importance of non-HDL-C still does not attracted sufficient attention of clinicians. With the further studies going on, the non-HDL-C will play more important role in lipid lowering therapy.