The relationship between high triglycerides and acute pancreatitis, you should understand these

In recent days, various units and companies have been organizing employee medical examinations. Regular examination of blood lipids is not unfamiliar, and there will be indicators such as TG (triglyceride), TC (total cholesterol), LDL-C (low-density lipoprotein cholesterol), and HDL-C (high-density lipoprotein cholesterol) on the report sheet. One of the most important indicators is LDL-C. Because LDL-C is the most important cause of atherosclerotic cardiovascular disease (ASCVD), lowering LDL-C can significantly reduce the risk of cardiovascular events.

 The relationship between high triglycerides and acute pancreatitis, you should understand these

statin is reduced LDL-C is the drug of choice, so the current lipid-lowering is also known as the “statin era”, but even the widespread use of high-dose statins still leaves about 70% of cardiovascular risk. Therefore, while paying attention to the dangers of hypercholesterolemia and emphasizing the important role of statins in the prevention and treatment of cardiovascular diseases, another dyslipidemia phenotype has attracted the attention of experts in recent years, namely triglyceride (TG). High (≥2.3 mmol/L). This dyslipidemia is common in patients with type 2 diabetes, obesity, metabolic syndrome, and cardiovascular disease and is an important risk factor for cardiovascular residuals.

So the problem is coming, TG is increasing, what are the hazards?

1. Hypertriglyceridemia is an important risk factor for coronary heart disease

TG is at the core of lipoproteins in the blood and transports as lipoproteins. Among various lipoproteins, chylomicrons (CM), very low-density lipoprotein (VLDL) and their residual TG content are high, and are collectively referred to as TG-rich protein (TRL). The elevated TG in the circulation actually reflects the increase in the concentration of TRL and its residual particles, which can be deposited in the arterial wall to promote atherosclerosis. Studies have shown that elevated TG can lead to a decrease in small, dense LDL with strong atherosclerosis and a decrease in large-particle high-density lipoprotein cholesterol (HDL-C) that promotes reverse cholesterol transport. The increase in TRL and its residual particles also promotes inflammation of the arterial wall and damage of endothelial cells. In addition, hypertriglyceridemia is often associated with coagulopathy, which plays an important role in acute coronary syndrome.

 The relationship between high triglycerides and acute pancreatitis, you should understand these

2. High TG blood The disease has a significant effect on the microvascular disease.

There is also a close relationship between the increase in TG and the risk of microvascular complications in diabetic patients. Studies have shown that TG elevation may be an important cause of retinal sclerosing exudation, macular degeneration, proliferative retinopathy, and the severity of retinopathy is positively correlated with TG levels. At the same time, TG and TGDL-rich VLDL can aggravate albuminuria. High TG is independently associated with the risk of microalbuminuria and large amounts of albuminuria in patients with type 2 diabetes. In addition, high TG is also significantly associated with autonomic neuropathy.

3. Severe high TG is one of the three major causes of acute pancreatitis

In addition to excessive alcohol consumption and cholelithiasis, hypertriglyceridemia (≥5.6 mmol/L) is Another major cause of acute pancreatitis, 10% of acute pancreatitis is caused by hypertriglyceridemia, and in pregnant women, this proportion is 50%. The cause of acute phositis caused by hypertriglyceridemia is not clear. Some experts explained that a large amount of TG-rich lipoprotein in the circulation is hydrolyzed by trypsin to form a large amount of free fatty acid (FFA), and FFA exceeds the binding capacity of plasma albumin. The remaining FFA self-aggregates to form microparticles that affect platelet function, cause pancreatic ischemia, and acinar cell damage. The acidic environment of the pancreas increases the toxicity of FFA, leading to acute pancreatitis. Some scholars believe that a large number of chylomicrons lead to increased blood viscosity, local blood flow in the pancreas, local acidosis damage the pancreatic capillaries.

 The relationship between high triglycerides and acute pancreatitis, you should understand these

LDL-C as the main target of lipid management may cause some medical workers to ignore the hazards of hypertriglyceridemia. However, the severe situation and the accompanying high residual blood vessel risk remind us that we should pay more attention to the management of TG. According to domestic and international lipid-lowering guidelines and a number of studies, niacin (Yiping® acipimox) and fibrates have advantages in reducing TG, with a reduction of 20-50%. Therefore, friends with increased blood lipids, not all high blood lipids are suitable for statin drugs, if the increase in blood lipids is mainly triglycerides (TG), we can choose niacin or fibrate drugs.