三酰甘油水平对冠状动脉粥样硬化性心脏病影响的研究进展_West China Medical Journal

Authors：

刘瑞双 ¹ , 黄方洋 ² ,  陈茂 ²

1. ;
2. ;

Corresponding author：

陈茂, Email: hmaochen@vip.sina.com

Keywords：

冠状动脉粥样硬化性心脏病; 三酰甘油; 预后

DOI：

10.7507/1002-0179.201608141

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冠状动脉粥样硬化性心脏病（冠心病）发病率高，预后差，是全球范围内导致死亡的主要原因之一。众所周知，高脂血症是冠心病的主要危险因素，目前多数研究主要聚焦于胆固醇和低密度脂蛋白水平对冠心病发病及预后的影响，而对于血脂中另一种成分—三酰甘油，对冠心病的影响研究相对较少。以往研究发现高三酰甘油血症患者冠心病发病率增加且预后不良；近期则研究报道了非空腹三酰甘油也与冠心病的发病及预后相关，同时发现高三酰甘油血症的影响在一些特殊人群（青年、女性）中尤为显著。基于最近对高三酰甘油血症在冠心病中的新认识，该文就三酰甘油水平对冠心病影响的研究进展进行了综述。

Citation： 刘瑞双, 黄方洋, 陈茂. 三酰甘油水平对冠状动脉粥样硬化性心脏病影响的研究进展. West China Medical Journal, 2017, 32(5): 763-767. doi: 10.7507/1002-0179.201608141 Copy

1.	Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2095-2128.
2.	陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告 2014》概要. 中国循环杂志, 2015(7): 617-622.
3.	胡大一, 郭艺芳. 甘油三酯增高的血脂异常防治中国专家共识. 中国医学前沿杂志:电子版, 2011(05): 115-120.
4.	中国成人血脂异常防治指南指导联合委员会. 中国成人血脂异常防治指南. 中华心血管病杂志, 2007, 35(5): 390-419.
5.	王彬尧, 王长谦. 甘油三酯与冠心病的关系. 国外医学. 心血管疾病分册, 2000(2): 79-81.
6.	李建薇, 田浩明. 餐后甘油三酯代谢障碍与冠心病. 国外医学: 内科学分册, 2001, 28(11): 461-463, 479.
7.	Zhao R, Ma X, Shen GX. Transcriptional regulation of plasminogen activator inhibitor-1 in vascular endothelial cells induced by oxidized very low density lipoproteins. Mol Cell Biochem, 2008, 317(1/2): 197-204.
8.	Kawakami A, Osaka M, Tani M, et al. Apolipoprotein CIII links hyperlipidemia with vascular endothelial cell dysfunction. Circulation, 2008, 118(7): 731-742.
9.	Canouï-Poitrine F, Luc G, Bard JM, et al. Relative contribution of lipids and apolipoproteins to incident coronary heart disease and ischemic stroke: the PRIME Study. Cerebrovasc Dis, 2010, 30(3): 252-259.
10.	Castelli WP. The triglyceride issue: a view from Framingham. Am Heart J, 1986, 112(2): 432-437.
11.	Assmann G, Schulte H, Von Eckardstein A. Hypertriglyceridemia and elevated lipoprotein(a) are risk factors for major coronary events in middle-aged men. Am J Cardiol, 1996, 77(14): 1179-1184.
12.	Hokanson JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease Independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk, 1996, 3(2): 213-219.
13.	Patel A, Barzi F, Jamrozik K, et al. Serum triglycerides as a risk factor for cardiovascular diseases in the Asia-Pacific region. Circulation, 2004, 110(17): 2678-2686.
14.	Bonaventure A, Kurth T, Pico F, et al. Triglycerides and risk of hemorrhagic stroke vs. ischemic vascular events: The Three-City Study. Atherosclerosis, 2010, 210(1): 243-248.
15.	Jeppesen J, Hein HO, Suadicani P, et al. Triglyceride concentration and ischemic heart disease: an eight-year follow-up in the Copenhagen Male Study. Circulation, 1998, 97(11): 1029-1036.
16.	Austin MA. Plasma triglyceride and coronary heart disease. Arterioscler Thromb, 1991, 11(1): 2-14.
17.	Emerging Risk Factors Collaboration, Di Angelantonio E, Sarwar N, et al. Major lipids, apolipoproteins, and risk of vascular disease. JAMA, 2009, 302(18): 1993-2000.
18.	Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation, 2011, 123(20): 2292-2333.
19.	Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet, 2005, 366(9493): 1267-1278.
20.	Faergeman O, Holme I, Fayyad R, et al. Plasma triglycerides and cardiovascular events in the treating to new targets and incremental decrease in end-points through aggressive lipid lowering trials of statins in patients with coronary artery disease. Am J Cardiol, 2009, 104(4): 459-463.
21.	Assmann G. Pro and con: high-density lipoprotein, triglycerides, and other lipid subfractions are the future of lipid management. Am J Cardiol, 2001, 87(5A): 2B-7B.
22.	He Y, Lam TH, Li LS, et al. Triglyceride and coronary heart disease mortality in a 24-year follow-up study in Xi'an, China. Ann Epidemiol, 2004, 14(1): 1-7.
23.	Werner C, Filmer A, Fritsch M, et al. Risk prediction with triglycerides in patients with stable coronary disease on statin treatment. Clin Res Cardiol, 2014, 103(12): 984-997.
24.	Miller M, Seidler A, Moalemi A, et al. Normal triglyceride levels and coronary artery disease events: the baltimore coronary observational long-term study. J Am Coll Cardiol, 1998, 31(6): 1252-1257.
25.	von Eynatten M, Hamann A, Twardella D, et al. Atherogenic dyslipidaemia but not total-and high-molecular weight adiponectin are associated with the prognostic outcome in patients with coronary heart disease. Eur Heart J, 2008, 29(10): 1307-1315.
26.	Yun KH, Shin IS, Rhee SJ, et al. Clinical significance of on-treatment triglyceride level in patients treated by percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome. Korean J Intern Med, 2009, 24(4): 330-336.
27.	Rubins HB. Triglycerides and coronary heart disease: implications of recent clinical trials. J Cardiovasc Risk, 2000, 7(5): 339-345.
28.	Goldbourt U, Behar S, Reicher-Reiss H, et al. Rationale and design of a secondary prevention trial of increasing serum high-density lipoprotein cholesterol and reducing triglycerides in patients with clinically manifest atherosclerotic heart disease (the Bezafibrate Infarction Prevention Trial). Am J Cardiol, 1993, 71(11): 909-915.
29.	Goldbourt U, Brunner D, Behar S, et al. Baseline characteristics of patients participating in the Bezafibrate Infarction Prevention (BIP) Study. Eur Heart J, 1998, 19(Suppl H): H42-H47.
30.	Rubins HB, Robins SJ, Collins D, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med, 1999, 341(6): 410-418.
31.	Lisak M, Demarin V, Trkanjec Z, et al. Hypertriglyceridemia as a possible independent risk factor for stroke. Acta Clin Croat, 2013, 52(4): 458-463.
32.	Miller M. Differentiating the effects of raising low levels of high-density lipoprotein cholesterol versus lowering normal triglycerides: further insights from the Veterans Affairs High-Density Lipoprotein Intervention Trial. Am J Cardiol, 2000, 86(12A): 23L-27L.
33.	Miller M, Cannon CP, Murphy SA, et al. Impact of triglyceride levels beyond low-density lipoprotein cholesterol after acute coronary syndrome in the PROVE IT-TIMI 22 trial. J Am Coll Cardiol, 2008, 51(7): 724-730.
34.	赵水平. 《甘油三酯增高的血脂异常防治中国专家共识》解读. 内科理论与实践, 2011, 6(6): 408-411.
35.	Driver SL, Martin SS, Gluckman TJ, et al. Fasting or nonfasting lipid measurements: it depends on the question. J Am Coll Cardiol, 2016, 67(10): 1227-1234.
36.	Patsch JR, Miesenböck G, Hopferwieser T, et al. Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arterioscler Thromb, 1992, 12(11): 1336-1345.
37.	Weintraub MS, Grosskopf I, Rassin T, et al. Clearance of chylomicron remnants in normolipidaemic patients with coronary artery disease: case control study over three years. BMJ, 1996, 312(736): 935-939.
38.	Braun D, Gramlich A, Brehme U, et al. Post-prandial lipaemia after a moderate fat challenge in normolipidaemic men with and without coronary artery disease. J Cardiovasc Risk, 1997, 4(2): 143-149.
39.	Nordestgaard BG, Benn M, Schnohr P, et al. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA, 2007, 298(3): 299-308.
40.	Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, et al. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA, 2008, 300(18): 2142-2152.
41.	Rajkumar C, Simpson H, Jennings GL, et al. Postprandial silent ischaemia following a fatty meal in patients with recently diagnosed coronary artery disease. J Hum Hypertens, 2000, 14(6): 391-394.
42.	Pineda J, Marín F, Marco P, et al. Premature coronary artery disease in young (age<45) subjects: interactions of lipid profile, thrombophilic and haemostatic markers. Int J Cardiol, 2009, 136(2): 222-225.
43.	厉其昀. 高甘油三酯血症与早发冠心病的关系. 现代医药卫生, 2006, 22(7): 974-975.
44.	杨金玲, 李广平. 青年急性心肌梗死临床特点与冠状动脉造影分析. 临床荟萃, 2014(9): 961-964.
45.	Sabik JF, Blackstone EH, Gillinov AM, et al. Occurrence and risk factors for reintervention after coronary artery bypass grafting. Circulation, 2006, 114(1 Suppl): I454-I460.
46.	Kasai T, Miyauchi K, Yanagisawa N, et al. Mortality risk of triglyceride levels in patients with coronary artery disease. Heart, 2013, 99(1): 22-29.
47.	Rami Helvaci M, Kaya H, Gundogdu M. Gender differences in patients with metabolic syndrome in coronary artery interventions. Med Glas (Zenica), 2013, 10(1): 75-80.
48.	Castelli WP. Cholesterol and lipids in the risk of coronary artery disease--the Framingham Heart Study. Can J Cardiol, 1988, 4(Suppl A): 5A-10A.

1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2095-2128.
2. 陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告 2014》概要. 中国循环杂志, 2015(7): 617-622.
3. 胡大一, 郭艺芳. 甘油三酯增高的血脂异常防治中国专家共识. 中国医学前沿杂志:电子版, 2011(05): 115-120.
4. 中国成人血脂异常防治指南指导联合委员会. 中国成人血脂异常防治指南. 中华心血管病杂志, 2007, 35(5): 390-419.
5. 王彬尧, 王长谦. 甘油三酯与冠心病的关系. 国外医学. 心血管疾病分册, 2000(2): 79-81.
6. 李建薇, 田浩明. 餐后甘油三酯代谢障碍与冠心病. 国外医学: 内科学分册, 2001, 28(11): 461-463, 479.
7. Zhao R, Ma X, Shen GX. Transcriptional regulation of plasminogen activator inhibitor-1 in vascular endothelial cells induced by oxidized very low density lipoproteins. Mol Cell Biochem, 2008, 317(1/2): 197-204.
8. Kawakami A, Osaka M, Tani M, et al. Apolipoprotein CIII links hyperlipidemia with vascular endothelial cell dysfunction. Circulation, 2008, 118(7): 731-742.
9. Canouï-Poitrine F, Luc G, Bard JM, et al. Relative contribution of lipids and apolipoproteins to incident coronary heart disease and ischemic stroke: the PRIME Study. Cerebrovasc Dis, 2010, 30(3): 252-259.
10. Castelli WP. The triglyceride issue: a view from Framingham. Am Heart J, 1986, 112(2): 432-437.
11. Assmann G, Schulte H, Von Eckardstein A. Hypertriglyceridemia and elevated lipoprotein(a) are risk factors for major coronary events in middle-aged men. Am J Cardiol, 1996, 77(14): 1179-1184.
12. Hokanson JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease Independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk, 1996, 3(2): 213-219.
13. Patel A, Barzi F, Jamrozik K, et al. Serum triglycerides as a risk factor for cardiovascular diseases in the Asia-Pacific region. Circulation, 2004, 110(17): 2678-2686.
14. Bonaventure A, Kurth T, Pico F, et al. Triglycerides and risk of hemorrhagic stroke vs. ischemic vascular events: The Three-City Study. Atherosclerosis, 2010, 210(1): 243-248.
15. Jeppesen J, Hein HO, Suadicani P, et al. Triglyceride concentration and ischemic heart disease: an eight-year follow-up in the Copenhagen Male Study. Circulation, 1998, 97(11): 1029-1036.
16. Austin MA. Plasma triglyceride and coronary heart disease. Arterioscler Thromb, 1991, 11(1): 2-14.
17. Emerging Risk Factors Collaboration, Di Angelantonio E, Sarwar N, et al. Major lipids, apolipoproteins, and risk of vascular disease. JAMA, 2009, 302(18): 1993-2000.
18. Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation, 2011, 123(20): 2292-2333.
19. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet, 2005, 366(9493): 1267-1278.
20. Faergeman O, Holme I, Fayyad R, et al. Plasma triglycerides and cardiovascular events in the treating to new targets and incremental decrease in end-points through aggressive lipid lowering trials of statins in patients with coronary artery disease. Am J Cardiol, 2009, 104(4): 459-463.
21. Assmann G. Pro and con: high-density lipoprotein, triglycerides, and other lipid subfractions are the future of lipid management. Am J Cardiol, 2001, 87(5A): 2B-7B.
22. He Y, Lam TH, Li LS, et al. Triglyceride and coronary heart disease mortality in a 24-year follow-up study in Xi'an, China. Ann Epidemiol, 2004, 14(1): 1-7.
23. Werner C, Filmer A, Fritsch M, et al. Risk prediction with triglycerides in patients with stable coronary disease on statin treatment. Clin Res Cardiol, 2014, 103(12): 984-997.
24. Miller M, Seidler A, Moalemi A, et al. Normal triglyceride levels and coronary artery disease events: the baltimore coronary observational long-term study. J Am Coll Cardiol, 1998, 31(6): 1252-1257.
25. von Eynatten M, Hamann A, Twardella D, et al. Atherogenic dyslipidaemia but not total-and high-molecular weight adiponectin are associated with the prognostic outcome in patients with coronary heart disease. Eur Heart J, 2008, 29(10): 1307-1315.
26. Yun KH, Shin IS, Rhee SJ, et al. Clinical significance of on-treatment triglyceride level in patients treated by percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome. Korean J Intern Med, 2009, 24(4): 330-336.
27. Rubins HB. Triglycerides and coronary heart disease: implications of recent clinical trials. J Cardiovasc Risk, 2000, 7(5): 339-345.
28. Goldbourt U, Behar S, Reicher-Reiss H, et al. Rationale and design of a secondary prevention trial of increasing serum high-density lipoprotein cholesterol and reducing triglycerides in patients with clinically manifest atherosclerotic heart disease (the Bezafibrate Infarction Prevention Trial). Am J Cardiol, 1993, 71(11): 909-915.
29. Goldbourt U, Brunner D, Behar S, et al. Baseline characteristics of patients participating in the Bezafibrate Infarction Prevention (BIP) Study. Eur Heart J, 1998, 19(Suppl H): H42-H47.
30. Rubins HB, Robins SJ, Collins D, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med, 1999, 341(6): 410-418.
31. Lisak M, Demarin V, Trkanjec Z, et al. Hypertriglyceridemia as a possible independent risk factor for stroke. Acta Clin Croat, 2013, 52(4): 458-463.
32. Miller M. Differentiating the effects of raising low levels of high-density lipoprotein cholesterol versus lowering normal triglycerides: further insights from the Veterans Affairs High-Density Lipoprotein Intervention Trial. Am J Cardiol, 2000, 86(12A): 23L-27L.
33. Miller M, Cannon CP, Murphy SA, et al. Impact of triglyceride levels beyond low-density lipoprotein cholesterol after acute coronary syndrome in the PROVE IT-TIMI 22 trial. J Am Coll Cardiol, 2008, 51(7): 724-730.
34. 赵水平. 《甘油三酯增高的血脂异常防治中国专家共识》解读. 内科理论与实践, 2011, 6(6): 408-411.
35. Driver SL, Martin SS, Gluckman TJ, et al. Fasting or nonfasting lipid measurements: it depends on the question. J Am Coll Cardiol, 2016, 67(10): 1227-1234.
36. Patsch JR, Miesenböck G, Hopferwieser T, et al. Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arterioscler Thromb, 1992, 12(11): 1336-1345.
37. Weintraub MS, Grosskopf I, Rassin T, et al. Clearance of chylomicron remnants in normolipidaemic patients with coronary artery disease: case control study over three years. BMJ, 1996, 312(736): 935-939.
38. Braun D, Gramlich A, Brehme U, et al. Post-prandial lipaemia after a moderate fat challenge in normolipidaemic men with and without coronary artery disease. J Cardiovasc Risk, 1997, 4(2): 143-149.
39. Nordestgaard BG, Benn M, Schnohr P, et al. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA, 2007, 298(3): 299-308.
40. Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, et al. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA, 2008, 300(18): 2142-2152.
41. Rajkumar C, Simpson H, Jennings GL, et al. Postprandial silent ischaemia following a fatty meal in patients with recently diagnosed coronary artery disease. J Hum Hypertens, 2000, 14(6): 391-394.
42. Pineda J, Marín F, Marco P, et al. Premature coronary artery disease in young (age<45) subjects: interactions of lipid profile, thrombophilic and haemostatic markers. Int J Cardiol, 2009, 136(2): 222-225.
43. 厉其昀. 高甘油三酯血症与早发冠心病的关系. 现代医药卫生, 2006, 22(7): 974-975.
44. 杨金玲, 李广平. 青年急性心肌梗死临床特点与冠状动脉造影分析. 临床荟萃, 2014(9): 961-964.
45. Sabik JF, Blackstone EH, Gillinov AM, et al. Occurrence and risk factors for reintervention after coronary artery bypass grafting. Circulation, 2006, 114(1 Suppl): I454-I460.
46. Kasai T, Miyauchi K, Yanagisawa N, et al. Mortality risk of triglyceride levels in patients with coronary artery disease. Heart, 2013, 99(1): 22-29.
47. Rami Helvaci M, Kaya H, Gundogdu M. Gender differences in patients with metabolic syndrome in coronary artery interventions. Med Glas (Zenica), 2013, 10(1): 75-80.
48. Castelli WP. Cholesterol and lipids in the risk of coronary artery disease--the Framingham Heart Study. Can J Cardiol, 1988, 4(Suppl A): 5A-10A.

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