The data shows that 1/3 of adults on the mainland have dyslipidemia. That is, one in every three adults around us is recruited.
Blood lipids actually include two components: triglycerides (TG) and cholesterol. Many people focus on cholesterol and don't know much about triglycerides.
Recently, The Lancet - Diabetes and Endocrinology published a paper detailing the various metabolic disorders that can be triggered by elevated triglycerides.
"Life Times" (search for "LT0385" in WeChat can be followed) combined with this discussion to interview experts, tell you the harm of high triglycerides, and recommend a set of "scientific regulation methods".
Experts interviewed
Yu Zaixin, chief physician of the Department of Cardiology, Xiangya Hospital, Central South University
Guo Yifang, vice president of Hebei Provincial People's Hospital and chief physician of the Department of Geriatric Cardiovascular Medicine
What are Triglycerides?
Triglycerides are actually fats, which is the scientific name of "oil".
Clinically, it is used as an important indicator, juxtaposed with total cholesterol, hdL-C (HDL-C, commonly known as "good cholesterol"), and low-density lipoprotein cholesterol (LDL-C, commonly known as "bad cholesterol"), becoming the basic item of "blood lipid examination".
Among the four indicators, the most susceptible to dietary influence is triglycerides: as long as the diet consumes more fat, triglyceride levels will increase; conversely, reduce the intake of high-fat foods, vegetarian diet, the value will decrease.
The main function of triglycerides is to supply and store energy, and also to fix and protect internal organs. It comes from two main sources:
The intestines absorb the fats in food, converting them into triglycerides;
The human liver and fat can synthesize triglycerides autonomously.
Triglyceride levels are generally influenced by a combination of genetic and environmental factors. Some people, even if they have a reasonable control of their diet, will be elevated due to their ability to metabolize triglycerides. Acquired factors are mostly due to the large amount of fat in the diet, or secondary to other diseases, such as diabetes, hypothyroidism, pancreatitis, etc.
Triglycerides are high, and the metabolism of the whole body is chaotic
The Lancet-Diabetes & Endocrinology article highlights that hypertriglyceremia is often accompanied by multiple metabolic abnormalities, especially in people with elevated triglycerides with excessive waist circumference:
Atherosclerosis risk
Triglycerides in plasma are found in chylomicrons and lipoprotein particles (such as very low-density lipoproteins, low-density lipoproteins) and are involved in the metabolism of cholesterol in the human body.
Triglycerides are too high and may have atherogenic effects, specifically:
Lipoprotein granules rich in triglycerides, which can partially lead directly to atherosclerosis;
Other lipoprotein abnormalities associated with hypertriglyceridemia, such as low or dysfunctional high-density lipoprotein (HDL), may also lead to atherosclerosis.
Insulin resistance
Obese, type 2 diabetics are more likely to develop hypertriglyceridemia. These populations are generally insulin resistant.
Some markers of hypertriglyceridemia and metabolic syndrome have been shown to precede the onset of type 2 diabetes and can predict the subsequent development of type 2 diabetes.
Risk of inflammation
Changes in the metabolic environment accompanied by hypertriglyceridemia are also associated with acute and chronic inflammation.
For example, the concentration of lipoproteins rich in triglycerides can rise abnormally after a meal and cause inflammation through a variety of mechanisms.
Risk of abnormal blood pressure
Hypertriglyceridemia and hypertension have multiple co-occurring mechanisms, including weight gain and visceral obesity.
Pro-inflammatory factors in patients with hypertriglyceridemia are also indirectly associated with cardiovascular damage.
Procoagulant state
The article emphasizes that an increase in the concentration of very low-density lipoprotein produced by the liver is associated with a procoagulant state. An increase in serum fibrinogen is associated with hypertriglyceridemia, and fibrates have been shown to reduce both triglyceride and fibrinogen concentrations.
Hypertriglyceridemia is also associated with increased concentrations of procoagulolipids and thrombin.
Fatty liver risk
Hypertriglyceridemia is also common in patients with non-alcoholic fatty liver disease.
The liver is the main source of triglyceride lipoprotein in the human body. Abnormal metabolism of triglycerides by the liver can lead to hypertriglyceridemia, while increased fat production in the liver can in turn promote the development of non-alcoholic fatty liver disease.
There is a tipping point on whether to take medicine or not
Normally, triglycerides range from 0.56 to 1.7 mmol/L, and the lower the relative, the better.
However, the criterion for diagnosing hypertriglyceridemia is ≥ 2.26 mmol/L. In other words, triglycerides exceeding 2.26 mmol/L are considered hypertriglyceridemia.
When this indicator is between 1.7 and 2.26 mmol/L, it is called marginal elevation.
Patients with well-known hypertriglyceridemia should be treated for the cause. First improve lifestyle, and then recommend medication if diet control and exercise are not up to standard for a period of time.
At this time the principles of the patient's application of the drug are:
When the patient's triglyceride level ≥ 5.6 mmol/L, fibrates should be given priority;
In patients with cardiovascular disease, after 2 to 3 months of lifestyle improvement and statin therapy, LDL cholesterol has reached the target, but triglycerides should be considered when the triglyceride ≥ 2.3 mmol/L.
People with severely elevated triglycerides, the blood drawn out looks white, called chyle blood.
Plasma in normal people (left) and plasma in patients with hypertriglyceridemia (right)
How can I lower triglyceride levels?
Hyperlipidemia in foreigners is mainly based on increased cholesterol; but for Chinese, hyperlipidemia is mainly based on increased triglycerides, which is greatly affected by diet and exercise.
The negative effects of increased triglycerides accumulate continuously. Even if someone does not smoke, blood pressure and weight are normal, but as long as the triglycerides exceed the standard for a long time, cardiovascular and metabolic status will still be threatened.
1
Control fat intake
Fried foods contain a lot of fat and should not be consumed too much. In addition, to control weight, do not exceed 24 body mass index.
You can learn the Mediterranean diet. The main components of the Mediterranean diet are fruits and vegetables, nuts, legumes, whole grains, etc., the oil is mainly olive oil, and the meat is mainly fish and poultry.
2
Eat less sweets
People with high triglycerides are very sensitive to sugars because they can aggravate elevated triglycerides.
Manfred Sandler, a cardiologist at the Cardiovascular Tissue in Atlanta, USA, said: "I stick to a plant-based diet, consume the right amount of protein, and avoid starch and processed sugar. This not only keeps cholesterol and triglyceride levels normal, but also helps with weight loss. ”
3
Rationally reduce stress and regulate emotions
Stress triggers an adrenaline-triglyceride reaction that raises LDL cholesterol levels.
Patients with hyperlipidemia should take time out of their busy schedule for 5 minutes, or go outdoors to relax and do some meditation exercises and yoga exercises.
In terms of work and life, set realistic goals, properly vent pressure, reasonably arrange work and life, and leave yourself some rest and entertainment time.
5
Avoid sedentary sitting
Developing the habit of regular exercise can help accelerate the breakdown of triglycerides. It is recommended to do at least 150 minutes of moderate-intensity aerobic exercise per week, 3 to 5 times a week, such as brisk walking, jogging, cycling, etc. ▲
Editor of this issue: Zheng Ronghua