糖尿病患者血脂管理中国专家共识(2024版)

Expert Consensus on the Lipid Management of Diabetic Patients(2024 Edition)

糖尿病是动脉粥样硬化性心血管疾病(ASCVD)的重要独立危险因素,血脂异常在糖尿病患者的ASCVD发生和发展中起关键作用。目前我国糖尿病患者中血脂异常患病率高且控制现状不容乐观。因此,为了加强糖尿病患者的血脂管理,中国医师协会内分泌代谢科医师分会和国家心血管病专家委员会心血管代谢医学专业委员会组织专家,根据中国糖尿病患者的血脂管理现状,参考国内外新的循证证据和指南,制定了《糖尿病患者血脂管理中国专家共识(2024版)》。本共识内容涵盖糖尿病患者的血脂谱特点和血脂异常流行病学现状以及糖尿病全人群的ASCVD危险分层和血脂管理流程,首次将低密度脂蛋白胆固醇(LDL-C)与非高密度脂蛋白胆固醇(非HDL-C)均作为糖尿病患者血脂干预的首要靶点,并对糖尿病特殊人群(包括儿童和青少年、≥75岁老年人以及合并慢性肾脏病、代谢相关脂肪性肝病、妊娠的患者)的血脂管理策略进行了推荐。本共识旨在传递重要临床进展,指导临床实践,以改善糖尿病患者的心血管结局。

Diabetes is a significant independent risk factor for atherosclerotic cardiovascular disease(ASCVD),with dyslipidemia playing a critical role in the initiation and progression of ASCVD in diabetic patients.Currently in China,the prevalence of dyslipidemia in diabetes is high,while the control rate remains low.Therefore,to enhance lipid management in patients with diabetes,the Endocrinology and Metabolism Physician Branch of Chinese Medical Doctor Association,in collaboration with the Experts’Committee of National Society of Cardiometabolic Medicine,has convened experts to develop a consensus on the management of dyslipidemia in patients with type 1 or type 2 diabetes.The development of this consensus is informed by the existing practices in lipid management among Chinese diabetic patients,incorporating contemporary evidence-based findings and guidelines from national and international sources.The consensus encompasses the lipid profile characteristics,the current epidemiological status of dyslipidemia,ASCVD risk stratification,and lipid management procedures in diabetic patients.For the first time,both low-density lipoprotein cholesterol(LDL-C)and non-high-density lipoprotein cholesterol(non-HDL-C)have been recommended as primary targets for lipid intervention in diabetic patients.The consensus also includes a summary and recommendations for lipid management strategies in special diabetic populations,including children and adolescents,individuals aged 75 years and older,patients with chronic kidney disease,metabolic-associated fatty liver disease,as well as those who are pregnant.This comprehensive consensus will contribute to the dissemination of key clinical advancements and guide clinical practice,aiming to improve cardiovascular outcomes in diabetic patients.