Lisak Marijana, Demarin Vida, Trkanjec Zlatko, Basić-Kes Vanja
Acta Clin Croat. 2013 Dec;52(4):458-63.
There are no reliable data on the relationship between ischemic stroke and elevated triglyceride levels. Results of previous studies have shown that elevated total cholesterol, high low-density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C) are modifiable risk factors for ischemic stroke. Recent evidence suggests that hypertriglyceridemia correlates with an increased risk of cardiovascular disease, particularly if the levels of HDL cholesterol are low and the levels of LDL cholesterol are high. The role of hypertriglyceridemia as an independent risk factor for stroke remains questionable, although correlation between elevated triglycerides and recurrent ischemic stroke has been established. Hypertriglyceridemia is an essential feature of metabolic syndrome, the most important risk factor for atherosclerosis and prothrombotic state, and both correlate with the increased risk of stroke. Lowering triglyceride levels might have a positive effect in stroke risk reduction. Efficacy of gemfibrozil was demonstrated in secondary stroke prevention in patients with coronary heart disease and elevated triglyceride levels. Fibrate derivatives might be utilized in primary stroke prevention, but their efficacy has not yet been established. There is substantial evidence to conclude that hypertriglyceridemia might be an independent risk factor for stroke, but additional studies are mandatory to confirm this presumption.
关于缺血性中风与甘油三酯水平升高之间的关系，目前尚无可靠数据。先前的研究结果表明，总胆固醇升高、低密度脂蛋白胆固醇（LDL-C）水平高以及高密度脂蛋白胆固醇（HDL-C）水平低是缺血性中风的可改变风险因素。最近的证据表明，高甘油三酯血症与心血管疾病风险增加相关，尤其是在HDL胆固醇水平低且LDL胆固醇水平高的情况下。尽管甘油三酯升高与复发性缺血性中风之间已建立关联，但高甘油三酯血症作为中风独立危险因素的作用仍存在疑问。高甘油三酯血症是代谢综合征的一个重要特征，代谢综合征是动脉粥样硬化和血栓前状态的最重要危险因素，二者均与中风风险增加相关。降低甘油三酯水平可能对降低中风风险有积极作用。吉非贝齐在冠心病和甘油三酯水平升高患者的二级中风预防中显示出疗效。贝特类衍生物可用于一级中风预防，但其疗效尚未得到证实。有大量证据可以得出结论，高甘油三酯血症可能是中风的独立危险因素，但还需要更多研究来证实这一推测。
