이상지혈증 = PG 4 : Comorbidity & 2013 KASL guideline ; Dyslipidemia

다국어 초록 (Multilingual Abstract)

Patients with type 2 diabetes have high rates of cardiovascular disease (CVD), much of which may be preventable with appropriate treatment of lipid abnormalities. Diabetic dyslipidemia most commonly manifests as elevated triglycerides and low levels of HDL cholesterol, with a predominance of small, dense LDL particles amid relatively normal LDL cholesterol levels. Elevated serum triglycerides commonly associate with insulin resistance. In diabetic patients, despite the insulin resistance of the gluconeogenic arm, persistently elevated hepatic lipogenesis in response to hyperinsulinemia could neatly account for the increased hepatic triglyceride output. Insulin`s ability to activate lipogenesis is mediated by both transcriptional and post-translational activation of SREBP-1c. Recently, we demonstrated that fenofibrate, which is a drug used to treat hypertriglyceridemia, decreases hyperinsulinemia-stimulated hepatic lipid synthesis through induction of ER membrane bound transcription factor, CREBH. In the study, we also found that fenofibrate and CREBH induce hepatic fibroblast growth factor 21 (FGF21) expression. FGF21 has emerged as an important metabolic regulator of glucose and lipid metabolism. In this symposium, I will review diabetic dyslipidemia and present the data showing positive regulators of hepatic FGF21 expression.