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Endorganschäden bei Fettstoffwechselstörungen

  • Schwerpunkt: Endorganschäden
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Zusammenfassung

Der Zusammenhang zwischen erhöhten LDL-Cholesterinwerten und der koronaren Herzerkrankung wird sowohl durch epidemiologische als auch pathophysiologisch-experimentelle Daten gestützt. Große Interventionsstudien mit Statinen konnten danach in den letzten Jahren zeigen, dass eine lipidsenkende Therapie zu einer hochsignifikanten Senkung kardialer Komplikationen führt. Obgleich apoplektische Insulte meist ebenfalls auf atherosklerotische Veränderungen zurückzuführen ist, bleibt der epidemiologische Zusammenhang zwischen Schlaganfall und erhöhten Lipidwerten weiter unklar. Daten aus neueren Interventionsstudien kommen jedoch zu dem Schluss, dass insbesondere eine Statintherapie zu einer signifikanten Senkung von Schlaganfällen führt. Erhöhte Cholesterinwerte stehen ebenfalls im Verdacht, den Verlauf chronischer Nierenerkrankungen ungünstig zu beeinflussen. Darüber hinaus stellen Cholesterinkristallembolien, v. a. nach Katheterinterventionen, eine seltene, jedoch bedrohliche Komplikation dar. Schwere Hypertriglyzeridämien sind mit dem Risiko einer akuten Pankreatitis behaftet und können in der Leber möglicherweise zur Entwicklung einer Steatosis hepatis beitragen.

Abstract

Epidemiological and experimental data have clearly demonstrated a strong association between elevated LDL-cholesterol levels and coronary heart disease. In concordance lipid-lowering trials with statins have shown a significant reduction of cardiovascular events. Although stroke is mainly caused by atherosclerotic vascular events, epidemiolgical data have so far failed to show a significant relationship between elevated lipid levels and stroke incidence. However, recent lipid intervention trials with statins have clearly demonstrated a significant reduction in stroke incidence. Moreover, elevated cholesterol levels are thought to contribute to progression of chronic renal insufficiency. In addition, cholesterol crystal emboli are a rare but frequently serious complication of vascular catheter interventions. Significant hypertriglyceridemia carries a significant risk of acute pancreatitis and is thought to contribute to the development of fatty liver disease.

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Authors and Affiliations

  1. Klinik II und Poliklinik für Innere Medizin, Universität zu Köln

    M. Faust &  W. Krone

  2. Klinik II und Poliklinik für Innere Medizin, Universität zu Köln, Joseph-Stelzmann-Straße 9, 50924, Köln

    W. Krone

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  1. M. Faust
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  2. W. Krone
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Correspondence to W. Krone.

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Faust, M., Krone, W. Endorganschäden bei Fettstoffwechselstörungen. Internist 44, 831–839 (2003). https://doi.org/10.1007/s00108-003-0954-0

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