Mszar Reed, Bart Sarah, Sakers Alexander, Soffer Daniel, Karalis Dean G
Department of Physiology, Georgetown University, Washington, DC 20057, USA.
Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT 06473, USA.
J Clin Med. 2023 Feb 9;12(4):1382. doi: 10.3390/jcm12041382.
Hypertriglyceridemia (HTG) is a prevalent medical condition in patients with cardiometabolic risk factors and is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), if left undiagnosed and undertreated. Current guidelines identify HTG as a risk-enhancing factor and, as a result, recommend clinical evaluation and lifestyle-based interventions to address potential secondary causes of elevated triglyceride (TG) levels. For individuals with mild to moderate HTG at risk of ASCVD, statin therapy alone or in combination with other lipid-lowering medications known to decrease ASCVD risk are guideline-endorsed. In addition to lifestyle modifications, patients with severe HTG at risk of acute pancreatitis may benefit from fibrates, mixed formulation omega-3 fatty acids, and niacin; however, evidence does not support their use for ASCVD risk reduction in the contemporary statin era. Novel therapeutics including those that target apoC-III and ANGPTL3 have shown to be safe, well-tolerated, and effective for lowering TG levels. Given the growing burden of cardiometabolic disease and risk factors, public health and health policy strategies are urgently needed to enhance access to effective pharmacotherapies, affordable and nutritious food options, and timely health care services.
高甘油三酯血症（HTG）在患有心脏代谢危险因素的患者中是一种常见的病症，如果未被诊断和治疗，会增加动脉粥样硬化性心血管疾病（ASCVD）的风险。当前指南将HTG确定为一个风险增强因素，因此建议进行临床评估和基于生活方式的干预，以解决甘油三酯（TG）水平升高的潜在继发原因。对于有ASCVD风险的轻度至中度HTG患者，单独使用他汀类药物治疗或与其他已知可降低ASCVD风险的降脂药物联合使用是指南认可的。除了生活方式的改变外，有急性胰腺炎风险的重度HTG患者可能会从贝特类药物、混合制剂ω-3脂肪酸和烟酸中获益；然而，在当代他汀类药物时代，证据并不支持将它们用于降低ASCVD风险。包括那些靶向载脂蛋白C-III和血管生成素样蛋白3的新型疗法已被证明对降低TG水平是安全、耐受性良好且有效的。鉴于心脏代谢疾病和危险因素的负担日益加重，迫切需要公共卫生和健康政策策略，以增加获得有效药物治疗、负担得起且营养丰富的食物选择以及及时的医疗服务的机会。
