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[High triglyceride, low HDL-cholesterol and risk of coronary heart disease]
1H:S Hvidovre Hospital, endokrinologisk afdeling.
Insights
High triglyceride and low HDL cholesterol levels are significant risk factors for coronary artery disease (CAD). A combined lipid profile offers better CAD risk prediction than total cholesterol alone, highlighting the need for comprehensive metabolic interventions.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Lipidology
Context:
- Hypercholesterolemia is a known risk factor for coronary artery disease (CAD).
- The predictive value of high triglyceride and low HDL cholesterol for CAD risk is less established.
- Insulin resistance is linked to characteristic dyslipidemias, including high triglycerides and low HDL cholesterol.
Purpose:
- To review data on the significance of high triglyceride and low HDL cholesterol as CAD risk factors.
- To advocate for the use of combined lipid profiles for enhanced CAD risk assessment.
- To emphasize the connection between metabolic abnormalities and cardiovascular risk.
Summary:
- High triglyceride and low HDL cholesterol are significant, independent risk factors for CAD.
- Combined lipid profiles (triglyceride, HDL cholesterol, total cholesterol) provide superior CAD risk information compared to total cholesterol alone.
- These lipid abnormalities are characteristic of insulin resistance, a core issue in glucose and insulin metabolism.
Impact:
- Suggests that interventions targeting glucose, insulin, and lipid metabolism are crucial for CAD prevention.
- Highlights the importance of identifying and managing insulin resistance and associated dyslipidemias early, even in children.
- Promotes a holistic approach to cardiovascular disease prevention beyond solely managing high cholesterol.
Abstract:
Hypercholesterolaemia is a strong risk factor of coronary artery disease (CAD). The importance of high triglyceride and low HDL cholesterol in predicting risk of CAD is less well-established. This review presents data showing that high triglyceride and low HDL cholesterol are important risk factors of CAD and suggests that combined lipid profiles of triglyceride, HDL cholesterol, and total cholesterol provide more information about risk of CAD than total cholesterol alone. High triglyceride and low HDL cholesterol is the characteristic dyslipidaemia seen in subjects with insulin resistance, a basic abnormality in glucose- and insulin metabolism. Since insulin resistance and raised triglyceride and decreased HDL cholesterol can be identified in children of patients with NIDDM, essential hypertension, and CAD, we suggest that efforts to prevent CAD should include interventions against all these associated abnormalities in glucose-, insulin-, and lipid metabolism and not only high cholesterol.