[Revision of old risk factors: triglycerides]

Abstract

Serum triglycerides are transported by low-density lipoproteins: chylomicrons and VLDL. In the blood compartment, these lipoproteins undergo the action of lipoprotein lipase and are transformed into more dense particles captured by the liver. Several epidemiology studies have evidenced a strong relationship between serum triglyceride level and ischemic cardiovascular risk. This relationship tapers of or disappears after corrections for age, weight and HDL level in multivariate analysis. A recent meta-analysis demonstrated that the relative risk of cardiovascular events reached 1.14 in men and 1.32 in women, independently of confounding factors. Thus at the population scale, the impact of triglycerides on cardiovascular risk is weak. Certain forms are associated with high cardiovascular risk. For example, agarose gel electrophoresis can be used to identify a form of hypertriglyceridemia characterized by an accumulation of two populations of VLDL (double pre-ss). The prevalence of clinically patent vascular manifestations is 4 times greater in patients with this form of dyslipidemia than in subjects with hypertriglyceridemia without the double pre-ss. These observations point out the need for developing discriminating diagnostic methods to identify hyptriglyceridemic individuals with high cardiovascular risk.