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超越指南：小儿高甘油三酯血症管理的观点。

Beyond the Guidelines: Perspectives on Management of Pediatric Patients with Hypertriglyceridemia.

机构信息

University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, AL, USA.

Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

Curr Atheroscler Rep. 2024 Nov;26(11):617-628. doi: 10.1007/s11883-024-01237-z. Epub 2024 Sep 30.

DOI:10.1007/s11883-024-01237-z
PMID:39347913
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11519174/
Abstract

PURPOSE OF REVIEW

To provide a comprehensive overview of hypertriglyceridemia (HTG) in youth, identifying gaps in categorizing triglyceride (TG) levels and management strategies, and exploring new therapies for TG reduction.

RECENT FINDINGS

Non-fasting TG levels as important cardiovascular (CV) risk indicators, with HTG's pathophysiology involving genetic and secondary factors affecting TG metabolism. Emerging treatments, including those affecting the lipoprotein lipase complex and inhibiting proteins like apoC3 and ANGPTL3, show promise. The review highlights the need for specific management approaches for youth, the significance of non-fasting TG levels, and the potential of new therapies in reducing CV and pancreatitis risks, advocating for further research on these treatments' efficacy and safety.

摘要

目的综述

全面概述青少年高甘油三酯血症（HTG），确定在分类甘油三酯（TG）水平和管理策略方面的差距，并探讨降低 TG 的新疗法。

最近的发现

非空腹 TG 水平作为重要的心血管（CV）风险指标，HTG 的病理生理学涉及影响 TG 代谢的遗传和继发因素。新兴的治疗方法，包括影响脂蛋白脂肪酶复合物和抑制载脂蛋白 C3 和 ANGPTL3 等蛋白的方法，显示出前景。该综述强调了针对青少年的具体管理方法的必要性、非空腹 TG 水平的重要性以及新疗法在降低 CV 和胰腺炎风险方面的潜力，倡导对这些治疗方法的疗效和安全性进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/778fe041e177/11883_2024_1237_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/baa1fef9bc30/11883_2024_1237_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/9e11b9ab6492/11883_2024_1237_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/778fe041e177/11883_2024_1237_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/baa1fef9bc30/11883_2024_1237_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/9e11b9ab6492/11883_2024_1237_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e0/11519174/778fe041e177/11883_2024_1237_Fig3_HTML.jpg

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本文引用的文献

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Evinacumab Reduces Triglyceride-Rich Lipoproteins in Patients with Hyperlipidemia: A Post-Hoc Analysis of Three Randomized Clinical Trials.依维那单抗降低高脂血症患者富含甘油三酯的脂蛋白：三项随机临床试验的事后分析
Cardiovasc Drugs Ther. 2024 Mar 6. doi: 10.1007/s10557-024-07567-z.
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Breaking the chains of lipoprotein lipase deficiency: A pediatric perspective on the efficacy and safety of Volanesorsen.打破脂蛋白脂肪酶缺乏症的束缚：伏洛列索治疗的疗效和安全性的儿科观点。
Mol Genet Metab. 2024 May;142(1):108347. doi: 10.1016/j.ymgme.2024.108347. Epub 2024 Feb 13.
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Childhood Non-HDL Cholesterol and LDL Cholesterol and Adult Atherosclerotic Cardiovascular Events.
儿童非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇与成人动脉粥样硬化性心血管事件。
Circulation. 2024 Jan 16;149(3):217-226. doi: 10.1161/CIRCULATIONAHA.123.064296. Epub 2023 Nov 28.
4
The Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease.甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值作为代谢综合征和心血管疾病的风险标志物
Diagnostics (Basel). 2023 Mar 1;13(5):929. doi: 10.3390/diagnostics13050929.
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Evinacumab in severe hypertriglyceridemia with or without lipoprotein lipase pathway mutations: a phase 2 randomized trial.依维莫司在伴有或不伴有脂蛋白脂肪酶通路突变的严重高三酰甘油血症中的疗效：一项 2 期随机试验。
Nat Med. 2023 Mar;29(3):729-737. doi: 10.1038/s41591-023-02222-w. Epub 2023 Mar 6.
6
Evinacumab, an ANGPTL3 Inhibitor, in the Treatment of Dyslipidemia.依维那库单抗，一种血管生成素样蛋白3抑制剂，用于治疗血脂异常。
J Clin Med. 2022 Dec 25;12(1):168. doi: 10.3390/jcm12010168.
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Circulation. 2022 May 3;145(18):1377-1386. doi: 10.1161/CIRCULATIONAHA.122.059266. Epub 2022 Apr 3.
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J Am Coll Cardiol. 2021 Aug 31;78(9):960-993. doi: 10.1016/j.jacc.2021.06.011. Epub 2021 Jul 28.
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