title: How do elevated triglycerides and low HDL-cholesterol affect inflammation and atherothrombosis?
abstract: This review article summarizes recent research into the mechanisms as to how elevated levels of triglyceride (TG) and low levels of high- density- lipoprotein cholesterol (HDL-C) contribute to inflammation and atherosclerosis. Evidence supports the role of TG-rich lipoproteins in signaling mechanisms via apolipoproteins C-III and free fatty acids leading to activation of NFKβ, VCAM-1 and other inflammatory mediators which lead to fatty streak formation and advanced atherosclerosis. Moreover, the cholesterol content in TG-rich lipoproteins has been shown to predict CAD risk better than LDL-C. In addition to reverse cholesterol transport, HDL has many other cardioprotective effects which include regulating immune function. The "functionality" of HDL appears more important than the level of HDL-C. Insulin resistance and central obesity underlie the pathophysiology of elevated TG and low HDL-C in metabolic syndrome and type 2 diabetes. Lifestyle recommendations including exercise and weight loss remain first line therapy in ameliorating insulin resistance and the adverse signaling processes from elevated levels of TG-rich lipoproteins and low HDL-C.
authors.affiliation: Beth Israel Deaconess Medical Center and Harvard Medical School, 375 Longwood Avenue, Room 433, Boston, MA 02215, USA. fwelty@bidmc.harvard.edu
authors.forename: Francine K
authors.initials: FK
authors.lastname: Welty
mesh_terms: D050197:Atherosclerosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000502:physiology*; D003324:Coronary Artery Disease / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood; D018836:Inflammation Mediators / Q000502:physiology; D024821:Metabolic Syndrome / Q000097:blood; D058226:Plaque, Atherosclerotic / Q000097:blood; D013927:Thrombosis / Q000097:blood*; D014280:Triglycerides / Q000097:blood / Q000502:physiology*
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D018836:Inflammation Mediators; D014280:Triglycerides