高甘油三酯血症与心血管风险降低

Hypertriglyceridemia and cardiovascular risk reduction.

作者信息

Jacobson Terry A, Miller Michael, Schaefer Ernst J

机构信息

Office of Health Promotion and Disease Prevention, Emory University, Atlanta, Georgia, USA.

Division of Cardiology, University of Maryland Medical Center, Baltimore, Maryland, USA.

出版信息

Clin Ther. 2007 May;29(5):763-777. doi: 10.1016/j.clinthera.2007.05.002.

DOI:10.1016/j.clinthera.2007.05.002

PMID:17697898

Abstract

BACKGROUND

Elevated triglyceride (TG) levels are prevalent among the US population, often occurring in persons who are overweight or obese, or who have type 2 diabetes or the metabolic syndrome. There is evidence that elevated TG levels may be a significant independent risk factor for coronary heart disease (CHD), particularly in women.

OBJECTIVE

This article reviews data on the epidemiology, associated risks, treatment, and prevention of hypertriglyceridemia, including recommended TG goals and available TG-lowering agents.

METHODS

MEDLINE was searched for articles published from 1990 through 2006 using the terms hypertriglyceridemia, dyslipidemia, and coronary heart disease, with subheadings for risk, statins, niacin, fibrates, thiazolidinediones, and omega-3 fatty acids. The reference lists of relevant articles were examined for additional citations. Publications discussing the epidemiology of hypertriglyceridemia, CHD risk, treatment guidelines for lipid management, clinical trials involving TG-lowering drugs, and outcomes for lipid-modifying therapies were selected for review.

RESULTS

Concern over the increasing rate of hypertriglyceridemia and its deleterious health consequences is reflected in the most recent National Cholesterol Education Program guidelines. Several lipid-lowering agents are available, including statins, fibrates, niacin, thiazolidinediones, and prescription omega-3 fatty acids. Clinical trials of these drugs have reported lowering of TG by 7% to 50%. Along with lifestyle changes, the use of combination pharmacotherapy to reduce lipid levels (including TG) may be an effective strategy in patients with dyslipidemia.

CONCLUSION

Use of strategies to manage TG levels, along with low-density lipoprotein cholesterol levels, is warranted to help reduce the risk of CHD.

摘要

背景

甘油三酯（TG）水平升高在美国人群中很普遍，常见于超重或肥胖者、2型糖尿病患者或患有代谢综合征的人群。有证据表明，TG水平升高可能是冠心病（CHD）的一个重要独立危险因素，尤其是在女性中。

目的

本文综述了有关高甘油三酯血症的流行病学、相关风险、治疗和预防的数据，包括推荐的TG目标和可用的TG降低药物。

方法

在MEDLINE数据库中检索1990年至2006年发表的文章，使用的检索词为高甘油三酯血症、血脂异常和冠心病，并使用风险、他汀类药物、烟酸、贝特类药物、噻唑烷二酮类药物和ω-3脂肪酸等副标题。检查相关文章的参考文献列表以获取更多引用。选择讨论高甘油三酯血症的流行病学、CHD风险、血脂管理治疗指南、涉及TG降低药物的临床试验以及血脂修饰疗法结果的出版物进行综述。

结果

最近的国家胆固醇教育计划指南反映了对高甘油三酯血症发病率上升及其有害健康后果的关注。有几种降脂药物可供选择，包括他汀类药物、贝特类药物、烟酸、噻唑烷二酮类药物和处方ω-3脂肪酸。这些药物的临床试验报告称，TG水平降低了7%至50%。除了生活方式的改变，联合药物治疗以降低血脂水平（包括TG）可能是血脂异常患者的一种有效策略。