Pirillo Angela, Catapano Alberico L
Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy.
Atheroscler Suppl. 2013 Aug;14(2):237-42. doi: 10.1016/S1567-5688(13)70004-7.
Epidemiological studies have established an association between high triglycerides (TG) plasma levels and increased cardiovascular risk. Increased TG levels, commonly coupled with low HDL-C levels, are common in high cardiovascular risk subjects including those with dyslipidemia, metabolic syndrome and type 2 diabetes. Management of hypertriglyceridemia (HTG) includes lifestyle modification for mild-to-moderate HTG and pharmacological therapies for the treatment of high and very high TG levels. Among drugs, fibrates, nicotinic acid and omega-3 polyunsaturated fatty acids may be considered. Omega-3 fatty acids reduce plasma TG levels by several mechanisms; beside the effects on TG, omega-3 can also influence the levels of other lipids and lipoproteins including HDL-C and LDL-C. Clinical trials have also shown that omega-3 fatty acid supplementation is effective also when added in combination with other lipid-lowering drugs. These findings suggest that omega-3 fatty acids may be usefully considered for the management of high TG levels.
流行病学研究已证实血浆高甘油三酯(TG)水平与心血管疾病风险增加之间存在关联。TG水平升高通常与低高密度脂蛋白胆固醇(HDL-C)水平相关,在包括血脂异常、代谢综合征和2型糖尿病患者在内的高心血管疾病风险人群中很常见。高甘油三酯血症(HTG)的管理包括针对轻度至中度HTG的生活方式改变以及针对高TG和极高TG水平的药物治疗。在药物方面,可以考虑贝特类药物、烟酸和ω-3多不饱和脂肪酸。ω-3脂肪酸通过多种机制降低血浆TG水平;除了对TG的影响外,ω-3还可影响其他脂质和脂蛋白的水平,包括HDL-C和低密度脂蛋白胆固醇(LDL-C)。临床试验还表明,ω-3脂肪酸补充剂与其他降脂药物联合使用时也有效。这些发现表明,ω-3脂肪酸可能对管理高TG水平有益。