[콕!건강]If you are diabetic… ‘Dyslipidemia’ needs to be managed more quickly, lower, and more actively

[아시아경제 이관주 기자] Dyslipidemia refers to a state in which total cholesterol in the blood, low-density (LDL) cholesterol, triglyceride, which is bad cholesterol that causes arteriosclerosis, or high-density (HDL) cholesterol, which is good cholesterol that prevents arteriosclerosis, is decreased. When LDL cholesterol is high, hypercholesterolemia, when triglycerides are high, hypertriglyceridemia, and when HDL cholesterol is decreased, it is called dyslipidemia. Dyslipidemia is a condition in which lipid components in the blood are excessive, and these lipid components accumulate on the walls of blood vessels and cause inflammation, which can cause cardiovascular diseases such as angina pectoris or myocardial infarction, so special attention is required.

Although the causes are diverse, they are largely divided into primary causes caused by specific gene mutations and secondary causes related to obesity, alcohol consumption, high carbohydrate and high-fat diets, thyroid, kidney, liver function abnormalities, and type 2 diabetes. Hypertriglyceridemia is closely related to obesity, alcohol consumption, type 2 diabetes, and unhealthy eating patterns, which are problems in modern society. Low HDL cholesterol is known to be caused by genetic predisposition, obesity, and smoking. Dyslipidemia refers to a total cholesterol level of 240 mg/dL, LDL cholesterol of 160 mg/dL, triglyceride level of 200 mg/dL or more, and HDL cholesterol of less than 40 mg/dL in men and 50 mg/dL in women. .

According to the ‘Fact Sheet 2022’ data of the Korean Society for Lipid and Atherosclerosis, the prevalence of dyslipidemia in adults aged 20 years and older was approximately 40%. In particular, dyslipidemia was found in 87% of diabetic patients, 72% of hypertension patients, and 53.7% of obese patients with a body mass index (BMI) of 25 or more in the prevalence of chronic diseases called modern diseases such as diabetes, hypertension, and obesity.

Among these, the most important comorbidity is diabetes. Diabetes itself causes various problems in the blood vessels. High blood glucose causes problems in several coronary arteries at once, often recurs even after treatment, and has a poor survival rate compared to non-diabetics. In addition, diabetes increases the levels of triglycerides and LDL cholesterol, and decreases HDL cholesterol, thereby exacerbating dyslipidemia.

In the case of a diabetic patient, even if the level of LDL cholesterol exceeds 100 mg/dL, it is diagnosed as dyslipidemia requiring specialist treatment. This is because even if the level of LDL cholesterol is not high, ‘very low density (VLDL) cholesterol’ increases, making atherosclerosis more likely. As such, diabetic patients need to be more proactive in the treatment and management of dyslipidemia. Hwang Yoo-chul, a professor at the Department of Endocrinology and Metabolism at Kyunghee University Hospital in Gangdong, said, “In diabetic patients, drug treatment is important to lower the LDL cholesterol level, which is the main goal of dyslipidemia management,” said Professor Hwang. Is “For the same lipid level, diabetic patients have a much higher risk of cardiovascular disease compared to non-diabetic people.”Treat earlier, more aggressively, with lower lipid targets“he emphasized.

If you are a diabetic but do not have cardiovascular disease, you should control your HDL cholesterol to less than 100 mg/dl. However, if you have cardiovascular disease, chronic kidney disease, high blood pressure, smoking, coronary artery disease or have a family history, it is recommended to adjust the level to less than 70 mg/dL. Professor Hwang said,For diabetic patients, management of dyslipidemia and hyperlipidemia is a very important part not only for the quality of life but also for the prevention and management of complications in the future. “he said.

Reporter Lee Gwan-ju leekj5@asiae.co.kr