Lavie C J, Milani R V
Department of Internal Medicine, Ochsner Clinic, New Orleans, Louisiana.
Am J Cardiol. 1994 Dec 15;74(12):1192-5. doi: 10.1016/0002-9149(94)90546-0.
Substantial data suggest that elevated triglycerides are associated with increased coronary risk, and may be an independent coronary risk factor. Although it is generally accepted that patients with hypertriglyceridemia can have marked improvement in lipids after vigorous nonpharmacologic therapy, data to support this belief are lacking. This study assessed 313 consecutive patients before and after outpatient phase II cardiac rehabilitation and exercise programs to compare the response of patients with elevated triglycerides (> or = 250 mg/dl; n = 39) to vigorous nonpharmacologic therapy with the response of patients with "normal" triglyceride levels (< 150 mg/dl; n = 157). The independent effects that baseline triglycerides, as well as other variables, had on improving lipids after nonpharmacologic therapy were also determined. After cardiac rehabilitation and exercise training, patients had improvement in total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol levels, low-density lipoprotein (LDL) cholesterol levels, LDL/HDL ratios, body mass index, percent body fat, and METs. Patients with hypertriglyceridemia were younger (p = 0.05) and had higher baseline body mass index (p < 0.001) and LDL/HDL ratios (p < 0.0001) but lower HDL cholesterol levels (p < 0.0001) than patients with low baseline triglycerides. Both groups had improvement in lipids, obesity indexes, and exercise capacity. However, patients with hypertriglyceridemia had significantly greater reductions in triglycerides (-31% vs +3%; p < 0.0001), but had less improvement in both LDL cholesterol levels (0% vs -4%; p < 0.01) and LDL/HDL ratios (-5% vs -9%; p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
大量数据表明，甘油三酯升高与冠状动脉风险增加相关，可能是一个独立的冠状动脉风险因素。尽管人们普遍认为，高甘油三酯血症患者在积极的非药物治疗后血脂可显著改善，但缺乏支持这一观点的数据。本研究评估了313例连续门诊患者在进行二期心脏康复和运动项目前后的情况，以比较甘油三酯升高（≥250mg/dl；n = 39）患者与甘油三酯水平“正常”（<150mg/dl；n = 157）患者对积极非药物治疗的反应。还确定了基线甘油三酯以及其他变量对非药物治疗后血脂改善的独立影响。心脏康复和运动训练后，患者的总胆固醇、甘油三酯、高密度脂蛋白（HDL）胆固醇水平、低密度脂蛋白（LDL）胆固醇水平、LDL/HDL比值、体重指数、体脂百分比和代谢当量均有所改善。与基线甘油三酯水平低的患者相比，高甘油三酯血症患者更年轻（p = 0.05），基线体重指数更高（p < 0.001），LDL/HDL比值更高（p < 0.0001），但HDL胆固醇水平更低（p < 0.0001）。两组患者的血脂、肥胖指标和运动能力均有改善。然而，高甘油三酯血症患者的甘油三酯显著降低（-31%对+3%；p < 0.0001），但LDL胆固醇水平（0%对-4%；p < 0.01）和LDL/HDL比值（-5%对-9%；p = 0.03）的改善较少。（摘要截选至250字）
