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Erschienen in: Wiener klinische Wochenschrift Education 1-4/2018

30.05.2018 | Lipidstoffwechselstörungen | DFP-Fortbildung

Nichtmedikamentöse Therapie von Fettstoffwechselstörungen: Möglichkeiten und Grenzen

verfasst von: Univ.-Prof. Dr. Christoph H. Saely, Raphael Gansch, Heinz Drexel

Erschienen in: Wiener klinische Wochenschrift Education | Ausgabe 1-4/2018

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Atherosklerotische Erkrankungen sind die mit Abstand häufigste Todesursache [1]; bei der Mehrheit der Erwachsenen liegt eine zumindest subklinische Atherosklerose vor [2]. Atherosklerose wird verursacht durch die Einlagerung von Cholesterin in die Wände von Arterien; das Cholesterin gelangt über LDL-Partikel in diese hinein. LDL-Cholesterin ist deshalb ein kausaler Risikofaktor für die Entstehung von Atherosklerose [3, 4].
Atherosklerotische Erkrankungen sind die häufigste Todesursache
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Literatur
2.
Zurück zum Zitat Nemetz PN, Smith CY, Bailey KR, Roger VL, Edwards WD, Leibson CL. Trends in coronary atherosclerosis: a tale of two population subgroups. Am J Med. 2016;129(3):307–14.PubMedCrossRef Nemetz PN, Smith CY, Bailey KR, Roger VL, Edwards WD, Leibson CL. Trends in coronary atherosclerosis: a tale of two population subgroups. Am J Med. 2016;129(3):307–14.PubMedCrossRef
5.
Zurück zum Zitat Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med. 1977;62(5):707–14.PubMedCrossRef Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med. 1977;62(5):707–14.PubMedCrossRef
6.
Zurück zum Zitat Ference BA, Robinson JG, Brook RD, Catapano AL, Chapman MJ, Neff DR, et al. Variation in PCSK9 and HMGCR and risk of cardiovascular disease and diabetes. N Engl J Med. 2016;375(22):2144–53.PubMedCrossRef Ference BA, Robinson JG, Brook RD, Catapano AL, Chapman MJ, Neff DR, et al. Variation in PCSK9 and HMGCR and risk of cardiovascular disease and diabetes. N Engl J Med. 2016;375(22):2144–53.PubMedCrossRef
7.
Zurück zum Zitat Drexel H, Aczel S, Marte T, Benzer W, Langer P, Moll W, et al. Is atherosclerosis in diabetes and impaired fasting glucose driven by elevated LDL cholesterol or by decreased HDL cholesterol? Diabetes Care. 2005;28(1):101–7.PubMedCrossRef Drexel H, Aczel S, Marte T, Benzer W, Langer P, Moll W, et al. Is atherosclerosis in diabetes and impaired fasting glucose driven by elevated LDL cholesterol or by decreased HDL cholesterol? Diabetes Care. 2005;28(1):101–7.PubMedCrossRef
8.
Zurück zum Zitat Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, et al. Ezetimibe added to Statin therapy after acute coronary syndromes. N Engl J Med. 2015;372(25):2387–97.PubMedCrossRef Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, et al. Ezetimibe added to Statin therapy after acute coronary syndromes. N Engl J Med. 2015;372(25):2387–97.PubMedCrossRef
9.
Zurück zum Zitat Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017;376(18):1713–22.PubMedCrossRef Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017;376(18):1713–22.PubMedCrossRef
10.
Zurück zum Zitat Fruchart JC. Selective peroxisome proliferator-activated receptor alpha modulators (SPPARMalpha): the next generation of peroxisome proliferator-activated receptor alpha-agonists. Cardiovasc Diabetol. 2013;12:82.PubMedPubMedCentralCrossRef Fruchart JC. Selective peroxisome proliferator-activated receptor alpha modulators (SPPARMalpha): the next generation of peroxisome proliferator-activated receptor alpha-agonists. Cardiovasc Diabetol. 2013;12:82.PubMedPubMedCentralCrossRef
11.
Zurück zum Zitat Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, et al. Plasma HDL cholesterol and risk of myocardial infarction: a mendelian randomisation study. Lancet. 2012;380(9841):572–80.PubMedPubMedCentralCrossRef Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, et al. Plasma HDL cholesterol and risk of myocardial infarction: a mendelian randomisation study. Lancet. 2012;380(9841):572–80.PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Drexel H, Aczel S, Marte T, Vonbank A, Saely CH. Factors predicting cardiovascular events in statin-treated diabetic and non-diabetic patients with coronary atherosclerosis. Atherosclerosis. 2010;208(2):484–9.PubMedCrossRef Drexel H, Aczel S, Marte T, Vonbank A, Saely CH. Factors predicting cardiovascular events in statin-treated diabetic and non-diabetic patients with coronary atherosclerosis. Atherosclerosis. 2010;208(2):484–9.PubMedCrossRef
14.
Zurück zum Zitat Drexel H. Statins, fibrates, nicotinic acid, cholesterol absorption inhibitors, anion-exchange resins, omega-3 fatty acids: which drugs for which patients? Fundam Clin Pharmacol. 2009;23(6):687–92.PubMedCrossRef Drexel H. Statins, fibrates, nicotinic acid, cholesterol absorption inhibitors, anion-exchange resins, omega-3 fatty acids: which drugs for which patients? Fundam Clin Pharmacol. 2009;23(6):687–92.PubMedCrossRef
15.
Zurück zum Zitat Saely CH, Eber B, Pfeiffer KP, Drexel H. Low serum LDL cholesterol in patients with type 2 diabetes: an analysis on two different patient populations. Int J Cardiol. 2010;144(3):394–8.PubMedCrossRef Saely CH, Eber B, Pfeiffer KP, Drexel H. Low serum LDL cholesterol in patients with type 2 diabetes: an analysis on two different patient populations. Int J Cardiol. 2010;144(3):394–8.PubMedCrossRef
16.
Zurück zum Zitat National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–421.CrossRef National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–421.CrossRef
17.
Zurück zum Zitat Drexel H, Saely CH, Langer P, Loruenser G, Marte T, Risch L, et al. Metabolic and anti-inflammatory benefits of eccentric endurance exercise—a pilot study. Eur J Clin Invest. 2008;38(4):218–26.PubMedCrossRef Drexel H, Saely CH, Langer P, Loruenser G, Marte T, Risch L, et al. Metabolic and anti-inflammatory benefits of eccentric endurance exercise—a pilot study. Eur J Clin Invest. 2008;38(4):218–26.PubMedCrossRef
18.
Zurück zum Zitat Fortson MR, Freedman SN, Webster PD 3rd. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134–9.PubMed Fortson MR, Freedman SN, Webster PD 3rd. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134–9.PubMed
19.
Zurück zum Zitat Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999–3058.PubMedCrossRef Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999–3058.PubMedCrossRef
20.
Zurück zum Zitat Schaefer EJ, Gleason JA, Dansinger ML. Dietary fructose and glucose differentially affect lipid and glucose homeostasis. J Nutr. 2009;139(6):1257s–62s.PubMedPubMedCentralCrossRef Schaefer EJ, Gleason JA, Dansinger ML. Dietary fructose and glucose differentially affect lipid and glucose homeostasis. J Nutr. 2009;139(6):1257s–62s.PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat Kovar J, Zemankova K. Moderate alcohol consumption and triglyceridemia. Physiol Res. 2015;64(Suppl 3):S371–S5.PubMed Kovar J, Zemankova K. Moderate alcohol consumption and triglyceridemia. Physiol Res. 2015;64(Suppl 3):S371–S5.PubMed
23.
Zurück zum Zitat Chait A, Brunzell JD. Chylomicronemia syndrome. Adv Intern Med. 1992;37:249–73.PubMed Chait A, Brunzell JD. Chylomicronemia syndrome. Adv Intern Med. 1992;37:249–73.PubMed
24.
Zurück zum Zitat Wood PD, Stefanick ML, Williams PT, Haskell WL. The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med. 1991;325(7):461–6.PubMedCrossRef Wood PD, Stefanick ML, Williams PT, Haskell WL. The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med. 1991;325(7):461–6.PubMedCrossRef
25.
Zurück zum Zitat Harris WS, Ginsberg HN, Arunakul N, Shachter NS, Windsor SL, Adams M, et al. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk. 1997;4(5–6):385–91.PubMed Harris WS, Ginsberg HN, Arunakul N, Shachter NS, Windsor SL, Adams M, et al. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk. 1997;4(5–6):385–91.PubMed
26.
Zurück zum Zitat Harris WS, Connor WE, Illingworth DR, Rothrock DW, Foster DM. Effects of fish oil on VLDL triglyceride kinetics in humans. J Lipid Res. 1990;31(9):1549–58.PubMed Harris WS, Connor WE, Illingworth DR, Rothrock DW, Foster DM. Effects of fish oil on VLDL triglyceride kinetics in humans. J Lipid Res. 1990;31(9):1549–58.PubMed
27.
Zurück zum Zitat Kontush A. HDL-mediated mechanisms of protection in cardiovascular disease. Cardiovasc Res. 2014;103(3):341–9.PubMedCrossRef Kontush A. HDL-mediated mechanisms of protection in cardiovascular disease. Cardiovasc Res. 2014;103(3):341–9.PubMedCrossRef
28.
Zurück zum Zitat Hernaez A, Fernandez-Castillejo S, Farras M, Catalan U, Subirana I, Montes R, et al. Olive oil polyphenols enhance high-density lipoprotein function in humans: a randomized controlled trial. Arterioscler Thromb Vasc Biol. 2014;34(9):2115–9.PubMedCrossRef Hernaez A, Fernandez-Castillejo S, Farras M, Catalan U, Subirana I, Montes R, et al. Olive oil polyphenols enhance high-density lipoprotein function in humans: a randomized controlled trial. Arterioscler Thromb Vasc Biol. 2014;34(9):2115–9.PubMedCrossRef
29.
Zurück zum Zitat Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90.PubMedCrossRef Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90.PubMedCrossRef
30.
Zurück zum Zitat Guasch-Ferre M, Hu FB, Martinez-Gonzalez MA, Fito M, Bullo M, Estruch R, et al. Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Med. 2014;12:78.PubMedPubMedCentralCrossRef Guasch-Ferre M, Hu FB, Martinez-Gonzalez MA, Fito M, Bullo M, Estruch R, et al. Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study. BMC Med. 2014;12:78.PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Patrick L, Uzick M. C‑reactive protein and the inflammatory disease paradigm: HMG-CoA reductase inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of the literature. Alternative medicine review : a journal of clinical therapeutic. Cardiovasc Dis. 2001;6(3):248–71. Patrick L, Uzick M. C‑reactive protein and the inflammatory disease paradigm: HMG-CoA reductase inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of the literature. Alternative medicine review : a journal of clinical therapeutic. Cardiovasc Dis. 2001;6(3):248–71.
32.
Zurück zum Zitat Lu Z, Kou W, Du B, Wu Y, Zhao S, Brusco OA, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008;101(12):1689–93.PubMedCrossRef Lu Z, Kou W, Du B, Wu Y, Zhao S, Brusco OA, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008;101(12):1689–93.PubMedCrossRef
33.
Zurück zum Zitat Nigovic B, Sertic M, Mornar A. Simultaneous determination of lovastatin and citrinin in red yeast rice supplements by micellar electrokinetic capillary chromatography. Food Chem. 2013;138(1):531–8.PubMedCrossRef Nigovic B, Sertic M, Mornar A. Simultaneous determination of lovastatin and citrinin in red yeast rice supplements by micellar electrokinetic capillary chromatography. Food Chem. 2013;138(1):531–8.PubMedCrossRef
34.
Zurück zum Zitat Del Gobbo LC, Falk MC, Feldman R, Lewis K, Mozaffarian D. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr. 2015;102(6):1347–56.PubMedPubMedCentralCrossRef Del Gobbo LC, Falk MC, Feldman R, Lewis K, Mozaffarian D. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr. 2015;102(6):1347–56.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Luo C, Zhang Y, Ding Y, Shan Z, Chen S, Yu M, et al. Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100(1):256–69.PubMedCrossRef Luo C, Zhang Y, Ding Y, Shan Z, Chen S, Yu M, et al. Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100(1):256–69.PubMedCrossRef
36.
Zurück zum Zitat Katan MB, Zock PL, Mensink RP. Trans fatty acids and their effects on lipoproteins in humans. Annu Rev Nutr. 1995;15:473–93.PubMedCrossRef Katan MB, Zock PL, Mensink RP. Trans fatty acids and their effects on lipoproteins in humans. Annu Rev Nutr. 1995;15:473–93.PubMedCrossRef
37.
Zurück zum Zitat Brouwer IA, Wanders AJ, Katan MB. Effect of animal and industrial trans fatty acids on HDL and LDL cholesterol levels in humans—a quantitative review. PLoS ONE. 2010;5(3):e9434.PubMedPubMedCentralCrossRef Brouwer IA, Wanders AJ, Katan MB. Effect of animal and industrial trans fatty acids on HDL and LDL cholesterol levels in humans—a quantitative review. PLoS ONE. 2010;5(3):e9434.PubMedPubMedCentralCrossRef
38.
Zurück zum Zitat Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69(1):30–42.PubMedCrossRef Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69(1):30–42.PubMedCrossRef
39.
Zurück zum Zitat Miettinen TA, Puska P, Gylling H, Vanhanen H, Vartiainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med. 1995;333(20):1308–12.PubMedCrossRef Miettinen TA, Puska P, Gylling H, Vanhanen H, Vartiainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med. 1995;333(20):1308–12.PubMedCrossRef
40.
Zurück zum Zitat Weingartner O, Lutjohann D, Ji S, Weisshoff N, List F, Sudhop T, et al. Vascular effects of diet supplementation with plant sterols. J Am Coll Cardiol. 2008;51(16):1553–61.PubMedCrossRef Weingartner O, Lutjohann D, Ji S, Weisshoff N, List F, Sudhop T, et al. Vascular effects of diet supplementation with plant sterols. J Am Coll Cardiol. 2008;51(16):1553–61.PubMedCrossRef
41.
Zurück zum Zitat Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C‑reactive protein. JAMA. 2003;290(4):502–10.PubMedCrossRef Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C‑reactive protein. JAMA. 2003;290(4):502–10.PubMedCrossRef
42.
Zurück zum Zitat Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Miller ER 3rd, Lin PH, et al. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) trial. Am J Clin Nutr. 2001;74(1):80–9.PubMedCrossRef Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Miller ER 3rd, Lin PH, et al. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) trial. Am J Clin Nutr. 2001;74(1):80–9.PubMedCrossRef
43.
Zurück zum Zitat Zeppetzauer M, Drexel H, Vonbank A, Rein P, Aczel S, Saely CH. Eccentric endurance exercise economically improves metabolic and inflammatory risk factors. Eur J Prev Cardiol. 2013;20(4):577–84.PubMedCrossRef Zeppetzauer M, Drexel H, Vonbank A, Rein P, Aczel S, Saely CH. Eccentric endurance exercise economically improves metabolic and inflammatory risk factors. Eur J Prev Cardiol. 2013;20(4):577–84.PubMedCrossRef
44.
Zurück zum Zitat Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390(10107):2050–62.PubMedCrossRef Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390(10107):2050–62.PubMedCrossRef
Metadaten
Titel
Nichtmedikamentöse Therapie von Fettstoffwechselstörungen: Möglichkeiten und Grenzen
verfasst von
Univ.-Prof. Dr. Christoph H. Saely
Raphael Gansch
Heinz Drexel
Publikationsdatum
30.05.2018
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift Education / Ausgabe 1-4/2018
Print ISSN: 1863-3579
Elektronische ISSN: 1863-3765
DOI
https://doi.org/10.1007/s11812-018-0090-3

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