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Understanding Triglycerides Levels and Cardiovascular Risk in Type 2 Diabetes
Triglycerides and Cardiovascular Disease Risk
Elevated Triglycerides as a Risk Factor
High triglyceride (TG) levels have been extensively studied as a risk factor for cardiovascular diseases (CVD) in the general population. However, their specific impact on individuals with type 2 diabetes mellitus (T2DM) remains a subject of ongoing research. A systematic review and meta-analysis involving 132,044 T2DM patients revealed that higher serum TG levels are associated with an increased risk of cardiovascular events. Specifically, the study found that for every 1-mmol/L increase in TG, the risk of CVD increased by 6%. Additionally, when TG levels were categorized from the highest to the lowest, the risk of CVD increased by 30%. Despite these associations, elevated TG levels alone cannot serve as an independent marker for increased cardiovascular risk in T2DM patients, suggesting that other lipid parameters and factors also play significant roles.
Impact of Triglyceride-Lowering Treatments
The potential benefits of lowering triglyceride levels to reduce cardiovascular risk have been explored through various treatments. Pemafibrate, a selective peroxisome proliferator-activated receptor α modulator, has shown promise in reducing TG levels. In a large-scale, multinational, double-blind, randomized controlled trial involving 10,497 patients with T2DM and mild-to-moderate hypertriglyceridemia, pemafibrate significantly reduced TG levels by 26.2% compared to placebo. Despite this reduction, the incidence of cardiovascular events did not significantly differ between the pemafibrate and placebo groups, indicating that lowering TG levels alone may not be sufficient to reduce cardiovascular risk in this population.
Conclusion
In summary, while elevated triglyceride levels are associated with an increased risk of cardiovascular events in individuals with type 2 diabetes, they cannot be considered an independent risk factor. Treatments aimed at lowering TG levels, such as pemafibrate, have shown efficacy in reducing TG and other lipid levels but have not demonstrated a significant reduction in cardiovascular events. This underscores the complexity of lipid management in T2DM patients and the need for a multifaceted approach to reduce cardiovascular risk effectively.
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