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2011AHA甘油三酯與心血管疾病共識聲明

2014-05-06 16:59 閱讀:1674 來源:愛愛醫(yī) 責(zé)任編輯:張子玲
[導(dǎo)讀] A long-standing association exists between elevated triglyc-eride levels and cardiovascular disease (CVD)。However,the extent to which triglycerides directly promote CVD orrepresent a biomarker of risk has been debated for 3 decades.

    《2011AHA甘油三酯與心血管疾病共識聲明》內(nèi)容簡介:

    A long-standing association exists between elevated triglyc-eride levels and cardiovascular disease (CVD)。However,the extent to which triglycerides directly promote CVD orrepresent a biomarker of risk has been debated for 3 decades.To this end, 2 National Institutes of Health consensusconferences evaluated the evidentiary role of triglycerides incardiovascular risk assessment and provided therapeutic rec-ommendations for hypertriglyceridemic states.

    《2011AHA甘油三酯與心血管疾病共識聲明》內(nèi)容預(yù)覽:

    3.1. Methodological

    Considerations and Effect ModificationTriglyceride has long been the most problematic lipid measure inthe evaluation of cardiovascular risk. First, the distribution ismarkedly skewed, which necessitates categorical definitions orlog transformations. Second, variability is high (Section 10) andincreases with the level of triglyceride.12Third, the stronginverse association with high-density lipoprotein cholesterol(HDL-C) and apolipoprotein (apo) AI, suggests an intricatebiological relationship that may not be most suitably representedby the results of multivariate **ysis. Finally, evidence fromprospective studies of the triglyceride association supports astronger link with CVD risk in people with lower levels ofHDL-C13,14and LDL-C13,14and with T2DM.15,16Such an effectmodification could obscure a modest but significant effect, asdemonstrated recently.

    In addition to the inverse association with HDL-C, triglyc-eride levels are closely aligned with T2DM, even thoughT2DM is not always examined as a confounding factor, andwhen it is, the diagnosis is commonly based on history. Yetat least 25% of subjects with T2DM are undiagnosed,18andthey are often concentrated within a hypertriglyceridemicpopulation.

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