Triglycerides as vascular risk factors: new epidemiologic insights.
Open accessAbstract
PURPOSE OF REVIEW: Targeting triglycerides as a vascular risk factor is justified because of the role of triglyceride-rich lipoproteins in atherogenesis. This review examines recent evidence connecting triglycerides with cardiovascular disease (CVD) in the context of advances in insights concerning the pathophysiology, population burden and prognostic impact of fasting versus nonfasting values. RECENT FINDINGS: Cross-sectional surveys indicate that mean triglyceride levels in the United States have increased in recent decades. Although elevated fasting triglycerides are consistently associated with increased CVD risk, adjustment for other risk factors (especially high-density lipoprotein cholesterol (HDL-C)) substantially attenuates this relationship. A recent meta-analysis of 27 prospective studies of western populations reported a triglyceride impact on CVD in both sexes, for both fasting and nonfasting values. Nonfasting triglycerides maintained an independent graded relationship with CVD in fully adjusted analyses, with elevated 4 h postprandial triglyceride imposing a 4.5-fold increment relative to lower levels. SUMMARY: Evidence supports a potential role for both fasting and nonfasting triglycerides as vascular risk factors, owing in part to the accompanying burden of atherogenic remnant particles, small dense low-density lipoprotein, reduced HDL-C and a high frequency of accompanying insulin resistance. Triglyceride-associated CVD risk occurs even in patients with low low-density lipoprotein cholesterol (LDL-C), and lowering both lipids provides more benefit than reducing LDL-C alone.
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Although triglyceride itself is not a component of arterial plaque, cholesterol within triglyceride-rich particles may contribute to plaque development.
“Although triglyceride itself is not a component of arterial plaque, it is thought that cholesterol within triglyceride-rich particles may contribute to plaque development (60, 61).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [61]
In “New Insights into the role of TG in Atherogenesis” (page unavailable), the paper says triglyceride-rich lipoproteins can enter the arterial wall and become foam cells, supporting their possible contribution to plaque development. It does not state that triglyceride itself is absent from plaque or specifically identify cholesterol within those particles as the contributing component. (LLM, conf=0.82)
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Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline
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- Authors
- Kannel, W. B., & Vasan, R. S.
- Affiliations
- Boston University (US)
- Corresponding author
- Kannel, William B
- Venue
- Current Opinion in Cardiology
- Published
- 2009-07
- Volume
- 24
- Issue
- 4
- Pages
- 345-350
- ISSN
- 0268-4705 (ISSN-L)
- PMC
- PMC3012388
- OpenAlex
- W2084500770
- Cited by
- 149
- References
- 48
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 9 · 2019: 2 · 2018: 5 · 2017: 7 · 2016: 8 · 2015: 12 · 2014: 13 · 2013: 16 · 2012: 16
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (2K24 HL 04334, N01‐HC25195, K24HL004334, N01-HC-025195)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- triglycerides, cardiovascular risk, triglyceride-rich lipoproteins, atherogenesis, fasting triglycerides, postprandial triglycerides, small dense LDL, HDL cholesterol, insulin resistance, lipid-lowering therapy
- MeSH terms
- Cardiovascular Diseases, Coronary Artery Disease, Humans, Insulin Resistance, Risk Factors, Triglycerides, United States, Hypertriglyceridemia
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