Emerging insights into the interplay between dyslipidemia and cardiometabolic diseases:mechanisms and therapeutic strategies

MA Run-ze; QUAN Nan-hu

doi:10.19538/j.nk2025110107

Abstract：Dyslipidemia,as a central pathological factor in cardiometabolic diseases,is intricately associated with multiple disorders including hypertension,type 2 diabetes mellitus(T2DM),and coronary heart disease.This article systematically reviews the potential mechanisms by which lipid abnormalities contribute to cardiometabolic diseases,such as endothelial dysfunction and inflammatory activation,and highlights evidence from Mendelian randomization studies confirming causal relationships between lipid levels and cardiovascular events.In T2DM,dyslipidemia and insulin resistance form a bidirectional vicious cycle,with altered lipoprotein particle profiles substantially increasing residual cardiovascular risk,particularly in patients with concomitant hypertension.Although current lipid-lowering therapies,such as statins,have markedly reduced cardiovascular burden,significant residual risk persists under guideline-directed management.This has prompted the exploration of novel therapeutic targets:proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors,lipoprotein(a)regulators,and pro-resolving lipid mediators,all of which hold translational potential.Furthermore,lipid variability has been identified as an independent determinant of cardiovascular outcomes beyond average lipid levels,underscoring the importance of long-term stability in lipid management.Combined lipid-lowering strategies-such as statins plus fibrates-and individualized treatment goals,including the comprehensive regulation of low-density lipoprotein cholesterol(LDL-C),triglycerides,and high-density lipoprotein cholesterol(HDL-C),represent key directions for therapeutic optimization in patients with metabolic syndrome and diabetes.Future studies should integrate lipidomic technologies to identify sensitive molecular biomarkers for precision interventions and address the treatment problems in specific populations,such as statin-intolerant patients,in order to further alleviate the global burden of cardiometabolic diseases.