Hypertriglyceridemia and cardiovascular risk

a cautionary note about metabolic confounding

Allan D. Sniderman, Patrick Couture, Seth Martin, Jacqueline DeGraaf, Patrick R. Lawler, William C. Cromwell, John T. Wilkins, George Thanassoulis

Research output: Contribution to journalArticle

Abstract

Triglycerides are the conventional tool to measure VLDLs, whereas LDL cholesterol (LDL-C) is the conventional tool to measure LDLs. Multiple epidemiological studies, including a series of genetically based analyses, have demonstrated that cardiovascular risk is related to triglycerides independently of LDL-C, and this has led to a series of new therapeutic agents designed specifically to reduce plasma triglycerides. The triglyceride hypothesis posits that increased levels of triglycerides increase cardiovascular risk and decreasing plasma triglycerides decreases cardiovascular risk. In this work, we will examine the validity of the triglyceride hypothesis by detailing the biological complexities associated with hypertriglyceridemia, the genetic epidemiological evidence in favor of hypertriglyceridemia, the evidence from the fibrate randomized clinical trials relating triglycerides and clinical outcomes, and the completeness of the evidence from the initial studies of novel mutations and the therapeutic agents based on these mutations that lower triglycerides. Because of the multiple metabolic links between VLDL and LDL, we will try to demonstrate that measuring triglycerides and LDL-C alone are inadequate to document the lipoprotein profile. We will try to demonstrate that apoB must be measured, as well as triglycerides and cholesterol, to have an accurate estimate of lipoprotein status.—Sniderman, A. D., P. Couture, S. S. Martin, J. DeGraaf, P. R. Lawler, W. C. Cromwell, J. T. Wilkins, and G. Thanassoulis. Hypertriglyceridemia and cardiovascular risk: a cautionary note about metabolic confounding.

Original languageEnglish (US)
Pages (from-to)1266-1275
Number of pages10
JournalJournal of Lipid Research
Volume59
Issue number7
DOIs
StatePublished - Jan 1 2018

Fingerprint

Hypertriglyceridemia
Triglycerides
LDL Cholesterol
Lipoproteins
Plasmas
Fibric Acids
Apolipoproteins B
Mutation
Cholesterol
Epidemiologic Studies
Randomized Controlled Trials

Keywords

  • Angiopoietin-like 3 protein
  • Apolipoprotein B
  • Apolipoprotein CIII
  • Apolipoprotein CIII inhibitor
  • Low density lipoprotein
  • Triglycerides
  • Very low density lipoprotein

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Cell Biology

Cite this

Sniderman, A. D., Couture, P., Martin, S., DeGraaf, J., Lawler, P. R., Cromwell, W. C., ... Thanassoulis, G. (2018). Hypertriglyceridemia and cardiovascular risk: a cautionary note about metabolic confounding. Journal of Lipid Research, 59(7), 1266-1275. https://doi.org/10.1194/jlr.R082271

Hypertriglyceridemia and cardiovascular risk : a cautionary note about metabolic confounding. / Sniderman, Allan D.; Couture, Patrick; Martin, Seth; DeGraaf, Jacqueline; Lawler, Patrick R.; Cromwell, William C.; Wilkins, John T.; Thanassoulis, George.

In: Journal of Lipid Research, Vol. 59, No. 7, 01.01.2018, p. 1266-1275.

Research output: Contribution to journalArticle

Sniderman, AD, Couture, P, Martin, S, DeGraaf, J, Lawler, PR, Cromwell, WC, Wilkins, JT & Thanassoulis, G 2018, 'Hypertriglyceridemia and cardiovascular risk: a cautionary note about metabolic confounding', Journal of Lipid Research, vol. 59, no. 7, pp. 1266-1275. https://doi.org/10.1194/jlr.R082271
Sniderman, Allan D. ; Couture, Patrick ; Martin, Seth ; DeGraaf, Jacqueline ; Lawler, Patrick R. ; Cromwell, William C. ; Wilkins, John T. ; Thanassoulis, George. / Hypertriglyceridemia and cardiovascular risk : a cautionary note about metabolic confounding. In: Journal of Lipid Research. 2018 ; Vol. 59, No. 7. pp. 1266-1275.
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