The triglyceride controversy: a review of the data

Although some studies indicate that elevated triglyceride levels are an independent risk factor for coronary heart disease (CHD), the significance of hypertriglyceridaemia in atherosclerosis and CHD remains controversial. While many epidemiologic case-control studies show a significant association between triglyceride levels and CHD, these studies do not consider other variables that may affect the significance of triglycerides in their analysis of the data (e.g. triglycerides and high density lipoproteins). The absence of a consensus on the role of elevated triglycerides is balanced by the flaws in the currently available statistical approaches to analysing triglyceride levels. An association between hypertriglyceridaemia and abnormally high concentrations of apolipoprotein (apo) B has also been observed. Some researchers suggest that apo B is a better predictor of angiographically proven coronary atherosclerosis than total cholesterol or low density lipoprotein cholesterol and triglycerides. Although no consensus yet exists on the triglyceride question, available data strongly suggest that triglycerides warrant serious consideration.