Gandotra Puneet, Miller Michael
Department of Medicine, University of Maryland Hospital, Division of Cardiology, Room S3B06, 22 South Greene Street, Baltimore, MD 21201, USA.
Curr Cardiol Rep. 2008 Nov;10(6):505-11. doi: 10.1007/s11886-008-0079-0.
Triglycerides' role in coronary heart disease (CHD) risk assessment has long been debated. Although meta-analyses have suggested that triglycerides are an independent risk factor for CHD, a consensus has emerged that triglycerides more appropriately represent a biomarker of CHD risk rather than an independent risk factor. Ongoing studies will determine whether triglyceride lowering confers additional CHD benefit beyond that attained via low-density lipoprotein (LDL) cholesterol reduction. The American Diabetes Association presently recommends lowering elevated triglycerides as a secondary therapeutic target after LDL cholesterol, whereas other organizations, such as the National Cholesterol Education Program, recommend non-high-density lipoprotein cholesterol as the second priority after attaining the LDL cholesterol goal. However, reducing very high triglycerides (ie, > 500 mg/dL) remains a sufficiently high priority in affected individuals.
甘油三酯在冠心病（CHD）风险评估中的作用长期以来一直存在争议。尽管荟萃分析表明甘油三酯是冠心病的独立危险因素，但已形成一种共识，即甘油三酯更恰当地代表冠心病风险的生物标志物而非独立危险因素。正在进行的研究将确定降低甘油三酯是否能在通过降低低密度脂蛋白（LDL）胆固醇所获得的益处之外，为冠心病带来额外益处。美国糖尿病协会目前建议，在将低密度脂蛋白胆固醇作为首要治疗目标后，将降低升高的甘油三酯作为次要治疗目标，而其他组织，如国家胆固醇教育计划，则建议在达到低密度脂蛋白胆固醇目标后，将非高密度脂蛋白胆固醇作为第二优先目标。然而，对于受影响的个体，降低极高的甘油三酯水平（即>500mg/dL）仍然是一个足够高的优先事项。
