What we often call blood lipids actually includes two components: triglycerides and cholesterol. Many people attach great importance to cholesterol levels and ignore triglycerides.
Recently, a study involving 60,000 people showed that elevated triglyceride levels in people under the age of 65 were an independent risk factor for myocardial infarction.
Experts interviewed
Chief physician of the Department of General Internal Medicine, Chongqing University Cancer Hospital, Long Bo, attending physician, You Zhimei
Yu Zaixin, Chief Physician, Department of Cardiology, Xiangya Hospital, Central South University
High triglycerides, heart breakdown
Triglycerides are actually fat, that is, the scientific name of oil, and the normal reference value is 0.45~1.69 mmol/L (mmol/L).
Triglycerides are involved in the metabolism of cholesterol in the human body, so clinically, it is ranked alongside total cholesterol, high-density lipoprotein cholesterol ("good" cholesterol), and low-density lipoprotein cholesterol ("bad" cholesterol) as a basic item of blood lipid examination.
In the study, the researchers selected 64,574 healthy physical examination people, including women
1.66 mmol/L), follow-up was about 11 years.
The results showed that participants with triglycerides > 1.66 mmol/L had a 59% increased risk of myocardial infarction compared to participants with triglycerides < 1.02 mmol/L during the follow-up period.
As triglyceride levels rise, the cumulative risk of myocardial infarction gradually increases. At 10.92 years of follow-up, the incidence of myocardial infarction in the above three groups was 0.23%, 0.40% and 0.69%, respectively.
That is to say, young and middle-aged people are very afraid of high triglycerides, and among various blood lipid indicators, triglycerides are independent predictors of myocardial infarction, and their association with cardiovascular events cannot be ignored.
Group 5 people focused on triglycerides
The body's energy is mainly converted into triglycerides for storage, and when needed, the body can directly break down to supply energy. In addition to energy supply, triglycerides also fix and protect internal organs.
Excessive triglycerides affect cardiovascular health because it thickens the blood, collects more cholesterol and "bad" cholesterol, slows down blood circulation, and induces atherosclerosis, coronary heart disease, cerebral infarction and other diseases.
The following 5 groups of people need to focus on triglyceride level monitoring:
Those with a history of atherosclerotic cardiovascular disease;
People with multiple risk factors (eg, hypertension, diabetes, hypothyroidism, obesity, smoking);
those with a family history of early-onset cardiovascular disease (ischemic cardiovascular disease before the age of 55 in male first-degree immediate relatives or before age 65 in female first-degree immediate relatives);
People with familial hyperlipidemia;
People with thickened Achilles tendons and xanthomas on the skin or tendons.
Adults aged 20~40, at least once every 5 years to test blood lipids; Men over 40 years of age and menopausal women are tested 1 time per year; Patients with atherosclerotic cardiovascular disease and their high-risk groups are tested once every 3~6 months.
Above 1.7 is dangerous, below 1.2 is ideal
In the "Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults" issued by mainland China in 2007, the criteria for determining triglycerides are:
< 1.70mmol/L is an appropriate level,
1.70~2.25mmol/L is marginal increase,
≥2.26 mmol/L is hypertriglyceridemia.
In 2022, the European Atherosclerosis Society issued a consensus statement with stricter standards:
When the fasting triglycerides ≥ 1.2mmol/L, triglycerides-rich lipoproteins and their residues have begun to accumulate in the blood;
When triglycerides ≥ 1.7mmol/L, the risk of cardiovascular disease is significantly increased.
The new consensus also provides risk stratification for triglyceride levels: less than 1.2 mmol/L is ideal; 1.2~1.7mmol/L is the critical level.
Two key steps to control triglycerides
Among the four indicators of blood lipids, the most susceptible to diet is triglycerides. If you eat more fat, the triglycerides will rise; Eat less fatty foods, and this value will decrease.
Hyperlipidemia in foreigners is mainly due to increased cholesterol, but for Chinese, hyperlipidemia is mainly due to increased triglycerides, which is greatly affected by diet and exercise.
Therefore, the two key steps in controlling hypertriglyceridemia - diet adjustment and weight loss. You can first control your diet and do more exercise to improve your metabolism, and then review it after 3 months.
Low fat
Fried foods contain a lot of fat and should not be eaten more. When choosing animal foods, try to avoid fatty meat, lard, egg yolks, animal offal and other meats with high cholesterol content.
Try the Mediterranean diet, which consists mainly of fruits and vegetables, nuts, legumes, whole grains, etc., oil is mainly olive oil, and meat is mainly fish and poultry.
Sugar control
People with high triglycerides are sensitive to sugars because they exacerbate elevated triglycerides.
Manfred Sandler, a cardiologist at the Atlanta Cardiovascular Organization, said: "I stick to a plant-based diet, consume moderate amounts of protein, and avoid processed sugar. This not only keeps cholesterol and triglyceride levels normal, but also helps with weight loss. ”
Make exercise a habit
Control your weight and do not exceed 24 body mass index. BMI = square of body weight / height (international unit kg/㎡).
Regular exercise helps accelerate triglyceride decomposition, it is recommended to do at least 150 minutes of moderate-intensity aerobic exercise every week, 3~5 times a week, such as brisk walking, jogging, cycling, etc.
Avoid stress build-up
Stress triggers an adrenergic-triglyceride reaction that raises LDL cholesterol levels.
In addition to busyness, you should take time to be in a daze for 5 minutes, or go outdoors to relax your mood, vent your stress appropriately, and leave yourself more time for entertainment.
Rational use of drugs
Commonly used lipid-lowering drugs are statins, fibrates and other varieties, to reduce cholesterol need to use statins, eat at night effect is good, because cholesterol metabolism is mainly at night; To reduce triglycerides, fibrates are the main ones, and it is best to take them in the morning, because triglyceride metabolism is strong during the day. ▲
Editor of this issue: Zheng Ronghua