Zhang Bai-Hui, Yin Fan, Qiao Ya-Nan, Guo Shou-Dong
Institute of Lipid Metabolism and Atherosclerosis, Innovative Drug Research Centre, School of Pharmacy, Weifang Medical University, Weifang, China.
Front Mol Biosci. 2022 May 25;9:909151. doi: 10.3389/fmolb.2022.909151. eCollection 2022.
Cardiovascular disease (CVD) is still the leading cause of death globally, and atherosclerosis is the main pathological basis of CVDs. Low-density lipoprotein cholesterol (LDL-C) is a strong causal factor of atherosclerosis. However, the first-line lipid-lowering drugs, statins, only reduce approximately 30% of the CVD risk. Of note, atherosclerotic CVD (ASCVD) cannot be eliminated in a great number of patients even their LDL-C levels meet the recommended clinical goals. Previously, whether the elevated plasma level of triglyceride is causally associated with ASCVD has been controversial. Recent genetic and epidemiological studies have demonstrated that triglyceride and triglyceride-rich lipoprotein (TGRL) are the main causal risk factors of the residual ASCVD. TGRLs and their metabolites can promote atherosclerosis via modulating inflammation, oxidative stress, and formation of foam cells. In this article, we will make a short review of TG and TGRL metabolism, display evidence of association between TG and ASCVD, summarize the atherogenic factors of TGRLs and their metabolites, and discuss the current findings and advances in TG-lowering therapies. This review provides information useful for the researchers in the field of CVD as well as for pharmacologists and clinicians.
心血管疾病（CVD）仍是全球首要死因，动脉粥样硬化是心血管疾病的主要病理基础。低密度脂蛋白胆固醇（LDL-C）是动脉粥样硬化的一个重要致病因素。然而，一线降脂药物他汀类药物仅能降低约30%的心血管疾病风险。值得注意的是，即使大量患者的LDL-C水平达到推荐的临床目标，动脉粥样硬化性心血管疾病（ASCVD）仍无法消除。此前，血浆甘油三酯水平升高是否与ASCVD存在因果关系一直存在争议。近期的遗传学和流行病学研究表明，甘油三酯和富含甘油三酯的脂蛋白（TGRL）是残余ASCVD的主要致病危险因素。TGRL及其代谢产物可通过调节炎症、氧化应激和泡沫细胞形成来促进动脉粥样硬化。在本文中，我们将对甘油三酯和TGRL代谢进行简要综述，展示甘油三酯与ASCVD之间关联的证据，总结TGRL及其代谢产物的致动脉粥样硬化因素，并讨论当前降甘油三酯治疗的研究结果和进展。本综述为心血管疾病领域的研究人员以及药理学家和临床医生提供了有用信息。
