Rizzo Manfredi, Berneis Kaspar
Department of Clinical Medicine and Emerging Diseases, University of Palermo, Via del Vespro 141, Palermo 90127, Italy.
J Atheroscler Thromb. 2005;12(5):237-9. doi: 10.5551/jat.12.237.
The term "lipid triad" or "atherogenic lipoprotein phenotype" has been introduced to describe a common form of dyslipidemia, characterized by three lipid abnormalities: increased plasma triglyceride levels, decreased HDL-cholesterol concentrations and the presence of small, dense LDL particles. It has been suggested that the clinical importance of the atherogenic lipoprotein phenotype probably exceeds that of LDL-cholesterol, because many more patients with coronary artery disease are found to have this trait than hypercholesterolaemia. There is a body of evidence that therapies effective against plasma HDL-cholesterol and triglycerides are associated with a strong reduction of cardiovascular risk; in addition, hypolipidemic treatment is able to increase LDL particle size and this increment correlates with regression of coronary stenosis. Recently, the Coordinating Committee of the National Cholesterol Education Program suggested that very high-risk patients may benefit from stronger lipid-lowering measures, a category of individuals that includes those with the atherogenic lipoprotein phenotype. Since the therapeutical modulation of each of the three components of the lipid triad is associated with a strong reduction in the risk of cardiovascular events, LDL size measurement may be extended as much as possible to patients at high risk of cardiovascular diseases.
术语“脂质三联征”或“致动脉粥样硬化脂蛋白表型”已被引入，用于描述一种常见的血脂异常形式，其特征为三种脂质异常：血浆甘油三酯水平升高、高密度脂蛋白胆固醇浓度降低以及存在小而密的低密度脂蛋白颗粒。有人提出，致动脉粥样硬化脂蛋白表型的临床重要性可能超过低密度脂蛋白胆固醇，因为发现患有冠状动脉疾病且具有此特征的患者比高胆固醇血症患者更多。有大量证据表明，有效降低血浆高密度脂蛋白胆固醇和甘油三酯的疗法与心血管风险的大幅降低相关；此外，降脂治疗能够增加低密度脂蛋白颗粒大小，且这种增加与冠状动脉狭窄的消退相关。最近，国家胆固醇教育计划协调委员会建议，极高风险患者可能从更强有力的降脂措施中获益，这一类别包括具有致动脉粥样硬化脂蛋白表型的个体。由于脂质三联征的三个组成部分中的每一个的治疗性调节都与心血管事件风险的大幅降低相关，因此低密度脂蛋白大小测量应尽可能扩大到心血管疾病高危患者。
