He Xiaonan
Beijing Anzhen Hospital affiliated to Capital Medical University
Chief Physician of the Emergency Critical Care Center
Triglycerides are 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") and have become the basic items of blood lipid examination.
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:
Exogenous: the intestines absorb fat from food, converting it into triglycerides;
Endogenous: Human liver and fat, can synthesize triglycerides autonomously.
Therefore, triglycerides are only partially related to diet, and even if the diet is reasonably controlled, triglycerides may be elevated.
If it is found that the triglycerides are elevated, then it is also necessary to check whether there are other diseases that lead to increased triglycerides, such as whether there is hypothyroidism, whether there are kidney function problems, whether there are other abnormal lipid metabolism and hyperuricemia, which need to be further clarified, and then can effectively reduce triglycerides.
【Note】
The general normal value is less than 1.7 mmol/L, and if it is greater than 1.7 mmol/L, it is called hypertriglyceridemia. Generally about 2mmol/L is called mild elevation, it is recommended that patients control diet, strengthen exercise, and then observe the trend of blood lipid changes. Generally greater than 4mmol/L to 5mmol/L, it means that the blood lipids are relatively high.
Triglycerides are high, and the metabolism of the whole body is chaotic
According to an article published in The Lancet-Diabetes and Endocrinology, hypertriglyceridemia is often accompanied by a variety of metabolic abnormalities, especially in people with elevated triglycerides and excessive waist circumference:
1. Risk of atherosclerosis
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.
2. 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.
3. 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.
4. 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.
5. Pro-coagulation 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.
6. 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.
How can I lower triglyceride levels?
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.
A healthy lifestyle is the main treatment that is highly advocated, that is, non-drug treatment: keeping your mouth shut, opening your legs, stabilizing your mood, and controlling your weight.
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.
3. Reasonably 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.
4. Avoid sitting for long periods of time
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.
Source: CCTV Life Circle
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