Custodis F, Laufs U
Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes.
Dtsch Med Wochenschr. 2011 Jul;136(30):1533-42. doi: 10.1055/s-0031-1281550. Epub 2011 Jul 25.
Elevated Triglyceride levels are associated with increased risk for atherosclerotic disease and additional vascular risk factors such as obesity, hypertension and impaired glucose tolerance. To estimate the individual cardiovascular risk of a patient with elevated triglycerides LDL- and HDL-cholesterol levels, concomitant diseases, composition of triglyceride rich lipoproteins and a family history for premature coronary heart disease are important. Primary goals for the management of hypertriglyceridemia are a reduction of cardiovascular risk and prevention of triglyceride associated complications such as the chylomicronemia syndrome. The basis of treatment are lifestyle changes: dietary intervention, alcohol avoidance, regular physical activity, weight loss and smoking cessation to modify risk factors. If triglyceride levels can not be sufficiently reduced by lifestyle intervention pharmacotherapy (nicotinic acid, fibrates and omega-3-acid ethyl esters) is indicated. Beyond reduction of triglyceride levels optimization of non-HDL-cholesterol by statin treatment is warranted to reduce vascular risk.
甘油三酯水平升高与动脉粥样硬化疾病风险增加以及肥胖、高血压和糖耐量受损等其他血管危险因素相关。为了评估甘油三酯、低密度脂蛋白和高密度脂蛋白胆固醇水平升高的患者的个体心血管风险，伴随疾病、富含甘油三酯脂蛋白的组成以及早发冠心病家族史很重要。高甘油三酯血症管理的主要目标是降低心血管风险和预防甘油三酯相关并发症，如乳糜微粒血症综合征。治疗的基础是生活方式改变：饮食干预、戒酒、定期体育活动、减肥和戒烟以改善危险因素。如果通过生活方式干预不能充分降低甘油三酯水平，则需要药物治疗（烟酸、贝特类药物和ω-3酸乙酯）。除了降低甘油三酯水平外，使用他汀类药物治疗优化非高密度脂蛋白胆固醇对于降低血管风险也是必要的。
