Valtimotautia sairastavista potilasta jopa neljäsosalla on suurentunut triglyseridipitoisuus
tehokkaasta lipidilääkityksestä huolimatta «Lawler PR, Kotrri G, Koh M, ym. Real-world risk of...»16. Statiinihoidon aikana LDL-kolesterolin tavoitepitoisuuden saavuttaneilla tyypin
2 diabetesta sairastavilla aterian jälkeinen triglyseridipitoisuuden suurentuminen
liittyi aterogeenisten apoB-48-hiukkasten viisi kertaa hitaampaan poistumiseen verrattuna
henkilöihin, joilla ei ollut diabetesta «Taskinen MR, Matikainen N, Björnson E, ym. Contrib...»17. Hypertriglyseridemian odotetaan edelleen lisääntyvän obesiteetin, metabolisen oireyhtymän
ja tyypin 2 diabeteksen esiintyvyyden lisääntymisen myötä.
Tutkimuksen perusteella tehokkaan statiinihoidon aikana todettu plasman triglyseriditaso
≥ 4 mmol/l suurentaa valtimotaudin riskiä 52 % verrattuna joukkoon, jolla triglyseridipitoisuus
on < 1 mmol/l «Lawler PR, Kotrri G, Koh M, ym. Real-world risk of...»16.
Keskeinen aterogeenisyyden mekanismi näillä triglyseridirikkailla lipoproteiineilla
on sama kuin LDL-partikkeleilla, eli ne siirtyvät endoteelin läpi verisuonen intimaan,
retentoituvat hepariinisulfaatti-glykoproteiinien välityksellä ja saavat aikaan vaahtosolujen
muodostumisen kautta ateroomaplakin muodostumisen «Tabas I, Williams KJ, Borén J. Subendothelial lipo...»11.
Krauss RM. Atherogenicity of triglyceride-rich lipoproteins. Am J Cardiol 1998;81:13B-17B
«PMID: 9526808»PubMed
Sarwar N, Danesh J, Eiriksdottir G ym. Triglycerides and the risk of coronary heart
disease: 10,158 incident cases among 262,525 participants in 29 Western prospective
studies. Circulation 2007;115:450-8 «PMID: 17190864»PubMed
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;3:213-9 «PMID: 8836866»PubMed
Bansal S, Buring JE, Rifai N ym. Fasting compared with nonfasting triglycerides and
risk of cardiovascular events in women. JAMA 2007;298:309-16 «PMID: 17635891»PubMed
Nordestgaard BG, Benn M, Schnohr P ym. Nonfasting triglycerides and risk of myocardial
infarction, ischemic heart disease, and death in men and women. JAMA 2007;298:299-308
«PMID: 17635890»PubMed
Jørgensen AB, Frikke-Schmidt R, West AS ym. Genetically elevated non-fasting triglycerides
and calculated remnant cholesterol as causal risk factors for myocardial infarction.
Eur Heart J 2013;34:1826-33 «PMID: 23248205»PubMed
Björnson E, Adiels M, Taskinen MR, ym. Triglyceride-rich lipoprotein remnants, low-density
lipoproteins, and risk of coronary heart disease: a UK Biobank study. Eur Heart J
2023;44(39):4186-4195 «PMID: 37358553»PubMed
Borén J, Packard C, Nordestgaard BG, ym. Great debate: Plasma triglycerides are an
important causal factor and therapeutic target for atherosclerotic cardiovascular
disease. Eur Heart J 2025;46(27):2643-2656 «PMID: 40214301»PubMed
Do R, Willer CJ, Schmidt EM, ym. Common variants associated with plasma triglycerides
and risk for coronary artery disease. Nat Genet 2013;45(11):1345-52 «PMID: 24097064»PubMed
Tabas I, Williams KJ, Borén J. Subendothelial lipoprotein retention as the initiating
process in atherosclerosis: update and therapeutic implications. Circulation 2007;116(16):1832-44
«PMID: 17938300»PubMed
Catapano AL, Graham I, De Backer G, ym. 2016 ESC/EAS Guidelines for the Management
of Dyslipidaemias. Eur Heart J 2016;37(39):2999-3058 «PMID: 27567407»PubMed
Emerging Risk Factors Collaboration, Di Angelantonio E, Gao P, ym. Lipid-related markers
and cardiovascular disease prediction. JAMA 2012;307(23):2499-506 «PMID: 22797450»PubMed
Boekholdt SM, Arsenault BJ, Mora S, ym. Association of LDL cholesterol, non-HDL cholesterol,
and apolipoprotein B levels with risk of cardiovascular events among patients treated
with statins: a meta-analysis. JAMA 2012;307(12):1302-9 «PMID: 22453571»PubMed
Robinson JG, Wang S, Jacobson TA. Meta-analysis of comparison of effectiveness of
lowering apolipoprotein B versus low-density lipoprotein cholesterol and nonhigh-density
lipoprotein cholesterol for cardiovascular risk reduction in randomized trials. Am
J Cardiol 2012;110(10):1468-76 «PMID: 22906895»PubMed
Lawler PR, Kotrri G, Koh M, ym. Real-world risk of cardiovascular outcomes associated
with hypertriglyceridaemia among individuals with atherosclerotic cardiovascular disease
and potential eligibility for emerging therapies. Eur Heart J 2020;41(1):86-94 «PMID: 31733058»PubMed
Taskinen MR, Matikainen N, Björnson E, ym. Contribution of intestinal triglyceride-rich
lipoproteins to residual atherosclerotic cardiovascular disease risk in individuals
with type 2 diabetes on statin therapy. Diabetologia 2023;66(12):2307-2319 «PMID: 37775612»PubMed
Cabodevilla AG, Izquierdo MC, Basu D, ym. Non-remnant triglyceride-rich lipoproteins
due to lipoprotein lipase deficiency increase atherosclerosis in mice. Nat Commun
2026;17(1):1458 «PMID: 41484108»PubMed
