Stefanutti Claudia, Labbadia Giancarlo, Athyros Vasilios G
Extracorporeal Therapeutic Techniques - Lipid Clinic and Atherosclerosis Prevention Centre - Immunohematology and Transfusion Medicine - Department of Molecular Medicine, University of Rome "Sapienza" - Umberto I Hospital-155, Viale del Policlinico, Rome, 00161, Italy (EU).
Curr Pharm Des. 2014;20(40):6238-48. doi: 10.2174/1381612820666140620120130.
Maintaining total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels within healthy limits decreases the risk of atherosclerotic vascular disease (AVD) and cardiovascular (CV) events. The predictive value of elevated TG levels for coronary artery disease (CAD) seen in univariate analysis tends to disappear on multivariate analyses, especially when correction is made for HDL-C. The relationship between TG and HDL-C is complex and not fully understood. Hydrolysis of TG by lipoprotein lipase converts HDL subclass 3 to a larger lipoprotein enriched in both phospholipid and TG. This process occurs in postprandial lipaemia (PPL). An additional factor for the complex relationship between TGs and CV risk is that the lipoproteins which transport plasma TG (chylomicrons, very low density lipoproteins and their remnants) are heterogeneous particles. Therefore, they may differ in their level of atherogenicity. PPL is a physiological process during which plasma lipoproteins and their subclasses undergo variations in concentration and composition following consumption of food, particularly fatty food. "Postprandial hyperlipidaemia" is the quantitative/qualitative alteration of this normal process. These lipoprotein alterations could play a role in the development of CV disease (CVD). However, lipid levels used to evaluate CV risk are usually measured in the fasting state. This review focuses on TG, PPL, postprandial hyperlipidaemia and non-HDL-C, their relationships and potential predictive role in atherogenesis and CVD.
将总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）水平维持在健康范围内可降低动脉粥样硬化性血管疾病（AVD）和心血管（CV）事件的风险。单变量分析中观察到的TG水平升高对冠状动脉疾病（CAD）的预测价值在多变量分析中往往会消失，尤其是在对HDL-C进行校正时。TG与HDL-C之间的关系复杂且尚未完全了解。脂蛋白脂肪酶对TG的水解将HDL亚类3转化为富含磷脂和TG的更大脂蛋白。这个过程发生在餐后血脂异常（PPL）中。TG与CV风险之间复杂关系的另一个因素是，运输血浆TG的脂蛋白（乳糜微粒、极低密度脂蛋白及其残粒）是异质性颗粒。因此，它们的致动脉粥样硬化程度可能不同。PPL是一个生理过程，在此过程中，进食食物，尤其是高脂肪食物后，血浆脂蛋白及其亚类的浓度和组成会发生变化。“餐后高脂血症”是这种正常过程的定量/定性改变。这些脂蛋白改变可能在心血管疾病（CVD）的发生发展中起作用。然而，用于评估CV风险的血脂水平通常在空腹状态下测量。本综述重点关注TG、PPL、餐后高脂血症和非HDL-C，它们之间的关系以及在动脉粥样硬化形成和CVD中的潜在预测作用。
