Science and Innovations in MedicineScience and Innovations in MedicineНаука и инновации в медицине2500-13882618-754XFSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation2151710.35693/2500-1388-2017-0-1-43-51ArticlesСтатьиResearch ArticleINNOVATIONS IN DIAGNOSTICS AND TREATMENT OF PATIENTS WITH HYPERTRIGLYCERIDEMIAИННОВАЦИИ В ДИАГНОСТИКЕ И ЛЕЧЕНИИ ПАЦИЕНТОВ С ГИПЕРТРИГЛИЦЕРИДЕМИЯМИSimerzinVV VСимерзинВ В

PhD, professor of the Faculty Therapy Department, Samara State Medical University

д.м.н., профессор кафедры факультетской терапии СамГМУ

simerzi@mail.ruFatenkovOV VФатенковО В

PhD, Associate Professor, head of the Faculty Therapy Department, Samara State Medical University

д.м.н., доцент, заведующий кафедрой факультетской терапии СамГМУ

kdmc@mail.ruGagloevaIV VГаглоеваИ В

PhD, chief specialist of the Territorial Compulsory Medical Insurance Fund of Samara region

д.м.н., главный специалист ТФОМС министерства здравоохранения Самарской области

gagloeva@samtfoms.ruGalkinaMA AГалкинаМ А

teaching assistant of the Faculty Therapy Department, Samara State Medical University

ассистент кафедры факультетской терапии СамГМУ.

mkmkmk1977@mail.ruPanishevaYaA AПанишеваЯ А

therapeutist of the Clinics of Faculty Therapy of Samara State Medical University

врач-терапевт клиники факультетской терапии СамГМУ

jana.panisheva@mail.ruKrasovskayaMA AКрасовскаяМ А

resident physician of the Clinics of Samara State Medical University

ординатор клиники факультетской терапии СамГМУ

geliosmax@yandex.ruSamara State Medical UniversityСамарский государственный медицинский университет1503201721NO1 (2017)№1 (2017)435110032020Copyright ©; 2017, Simerzin V.V., Fatenkov O.V., Gagloeva I.V., Galkina M.A., Panisheva Y.A., Krasovskaya M.A.Copyright ©; 2017, Симерзин В.В., Фатенков О.В., Гаглоева И.В., Галкина М.А., Панишева Я.А., Красовская М.А.2017Simerzin V.V., Fatenkov O.V., Gagloeva I.V., Galkina M.A., Panisheva Y.A., Krasovskaya M.A.Симерзин В.В., Фатенков О.В., Гаглоева И.В., Галкина М.А., Панишева Я.А., Красовская М.А.https://creativecommons.org/licenses/by/4.0https://innoscience.ru/2500-1388/article/view/21517

This article presents innovative techniques for diagnostics, risk stratification and treatment of patients with hypertriglyceridemia. Hypertriglyceridemia is not only known as an independent risk factor of cardiovascular diseases, but also its high level can become a cause of acute pancreatitis.

В статье представлен обзор инновационных технологий по диагностике пациентов с гипертриглицеридемиями. Отмечено, что гипертриглицеридемия является не только независимым фактором 10-летнего риска смерти от сердечно-сосудистых заболеваний, но и при ее высоком уровне причиной развития острого панкреатита. Отражены современные принципы стратификации риска у пациентов с гипертриглицеридемиями и их фармакотерапии.

hypertriglyceridemiarisk stratificationdiagnostics and treatmentгипертриглицеридемиядислипиде-мияриск-стратификациядиагностика и лечениеShi Y, Cheng D. Beyond triglyceride synthesis: the dynamic functional roles of MGAT and DGAT enzymes in energy metabolism. Am J Physiol Endocrinol Metab. 2009; 297 (1): E10-8. doi: 10.1152/ajpendo.90949.2008MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20536 high-risk individuals: a randomised placebo controlled trial THE LANCET. Vol 360. July 6, 2002. www.thelancet.comSarwar N, Sandhu MS, Ricketts SL, Butterworth AS, Di Angelantonio E, Boekholdt SM, Ouwehand W, Watkins H, Samani NJ, Saleheen D, Lawlor D, Reilly MP, Hingorani AD, Talmud PJ, Danesh J. Triglyceride- mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet 2010;375:1634-1639. doi: 10.1016/S0140-6736(10)60545-4Chapman MJ, Ginsberg HN, Amarenco P, Andreotti F, Boren J, Catapano AL, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA, Lesnik P, Masana L, Nordestgaard BG, Ray KK, Reiner Z, Taskinen MR, Tokgozoglu L, Tybjaerg-Hansen A, Watts GF;, and the European Atherosclerosis Society Consensus Panel. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J 2011; 32: 1345-61. doi: 10.1093/ eurheartj/ehr112. Epub 2011 Apr 29Talayero BG, Sacks FM. The role of triglycerides in atherosclerosis. Curr Cardiol Rep. 2011; 13 (6): 544-52. doi: 10.1007/s11886-011-0220-3Brahm A, Hegele RA. Hypertriglyceridemia. Nutrients. 2013, 5 (3): 981-1001. doi:10.3390/nu5030981Robert A Hegele, Henry N Ginsberg, M John Chapman, Borge G Nordestgaard, Jan Albert Kuivenhoven, Maurizio Averna, Jan Boren, Eric Bruckert, Alberico L Catapano, Olivier S Descamps, G Kees Hovingh, Steve E Humphries, Petri T Kovanen, Luis Masana, Paivi Pajukanta, Klaus G Parhofer, Frederick J Raal, Kausik K Ray, Raul D Santos, Anton F H Stalenhoef, Erik Stroes, Marja-Riitta Taskinen, Anne Tybjsrg-Hansen, Gerald F Watts, Olov Wiklund. The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinol 2014 (2): 655-666. www.thelancet.com/diabetes-endocrinology. doi: 10.1016/S2213-8587(13)70191-8Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97Catapano AL, Reiner Z, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Perrone Filardi P, Riccardi G, Storey RF, Wood D. Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS), and the ESC Committee for Practice Guidelines 2008-2010 and 2010-2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2011; 217 (suppl 1): S1-44). DOI:10.1016/j.atherosclerosis.2011.06.012Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, Stalenhoef AF. Endocrine Society. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97: 2969-89.doi:10.1210/jc.2011-3213Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, Boekholdt SM, Khaw KT, Gudnason V.Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262 525 participants in 29 Western prospective studies. Circulation 2007; 115: 450-58Sarwar N, Sattar N. Triglycerides and coronary heart disease: have recent insights yielded conclusive answers? Curr Opin Lipidol 2009; 20: 275-81.doi: 10.1097/ MOL.0b013e32832dd4dcMorrison A, Hokanson JE. The independent relationship between triglycerides and coronary heart disease. Vasc Health Risk Manag. 2009;5(1):89-95. E-pub 2009 Apr 8Austin MA, Hokanson JE, Edwards KL Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol 1998;81:7B-12BYuan G, Al-Shali KZ, Hegele RA. Hypertriglyceridemia: its etiology, effects and treatment. CMAJ, 2007, 176: 1113-20Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D, and the European Association for Cardiovascular Prevention & Rehabilitation, and the ESC Committee for Practice Guidelines (CPG) 20082010 and 2010-2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011, 32: 1769-818. doi: 10.1093/eurheartj/ ehr158Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA, 2007; 298: 299-308Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, Nordestgaard BG. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA 2008, 300: 2142-52.doi: 10.1001/ jama.2008.621Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorolo K, Keil U; EUROASPIRE Study Group. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16:121-137Bansal S1, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA. 2007 Jul 18;298(3):309-16The ACCORD Study Group. Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus. N Engl J Med 2010. Published on March 14, 2010, updated on March 18, 2010, at NEJM.org. DOI: 10.1056/NEJMoa1001282Assmann G, MD, FRCP; Cullen P, MD, FRCPI; Schulte H, PhD. Simple Scoring Scheme for Calculating the Risk of Acute Coronary Events Based on the 10-Year Follow-Up of the Prospective Cardiovascular Munster (PROCAM) Study. Downloaded from http://circ.ahajournals.org/ Downloaded from/ by guest on January 4, 2017Di Angelantonio E, Sarwar N, Perry P, Kaptoge S, Ray KK, Thompson A, Wood AM, Lewington S, Sattar N, Packard CJ, Collins R, Thompson SG, Danesh J. Emerging Risk Factors Collaboration. Major lipids, apolipoproteins, and risk of vascular disease. JAMA. 2009 Nov 11;302(18):1993-2000. PubMed PMID: 19903920. doi: 10.1001/jama.2009.1619Varbo A, Benn M, Tybjorg-Hansen A, Jorgensen AB, Frikke Schmidt R, Nordestgaard BG. Remnant cholesterol as a causal risk factor for ischemic heart disease. J Am Coll Cardiol 2013; 61: 427-36. doi: 10.1016/j.jacc.2012.08.1026Jorgensen AB, Frikke-Schmidt R, West AS, Grande P, Nordestgaard BG, Tybjsrg-Hansen A. Genetically elevated non-fasting triglycerides and calculated remnant cholesterol as causal risk factors for myocardial infarction. Eur Heart J 2013; 34: 1826-33. doi:10.1093/eurheartj/ehs431Anderson TJ, Gregoire J, Hegele RA, Couture P, Mancini GB, McPherson R, Francis GA, Poirier P, Lau DC, Grover S, Genest J Jr, Carpentier AC, Dufour R, Gupta M, Ward R, Leiter LA, Lonn E, Ng DS, Pearson GJ, Yates GM, Stone JA, Ur E. 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol 2013; 29: 151-67. doi: 10.1016/j. cjca.2012.11.032NIH-NCEP. Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Executive Summary. 2004; NIH. Nugent AP. LIPGENE: an EU project to tackle the metabolic syndrome. Biochimie. 2005; 87 (1):129-32Кухарчук В.В., Коновалов Г.А., Гапявич А.С. Диагностика и коррекция нарушений липидного обмена с цепью профилактики и печения атеросклероза. Российские рекомендации пересмотр. М., 2012Morrone D, Weintraub WS, Toth PP, et al. Lipid-altering efficacy of ezetimibe plus statin and statin monotherapy and identification of factors associated with treatment response: a pooled analysis of over 21,000 subjects from 27 clinical trials. Atherosclerosis 2012; 223: 251-61Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R, Simes R, and the Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005; 366: 1267-78Boekholdt SM, Arsenault BJ, Mora S, Pedersen TR, LaRosa JC, Nestel PJ, Simes RJ, Durrington P, Hitman GA, Welch KM, DeMicco DA, Zwinderman AH, Clearfieldo MB, Downs JR, Tonkin AM, Colhoun HM, Gotto AM Jr, Ridker PM, Kastelein JJ.Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis. JAMA 2012; 307: 1302-09. doi: 10.1001/ jama.2012.366Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, de Graaf J, Furberg CD. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes 2011; 4: 337-45. doi: 10.1161/CIRCOUTCOMES.110.959247Staels B, Dallongeville J, Auwerx J, Schoonjans K, Leitersdorf E, Fruchart JC. Mechanism of action of fibrates on lipid and lipoprotein metabolism. Circulation 1998; 98: 2088-93Michos ED, Sibley CT, Baer JT, Blaha MJ, Blumenthal RS. Niacin and statin combination therapy for atherosclerosis regression and prevention of cardiovascular disease events: reconciling the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) trial with previous surrogate endpoint trials. J Am Coll Cardiol, 59 (2012): 2058-2064Kamanna V.S., Kashyap M.L. Nicotinic acid (niacin) receptor agonists: will they be useful therapeutic agents? Am J Cardiol 2007(100):53-61Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA 1975;231:360-381Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, McBride R, Teo K, Weintraub W. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 2011;365:2255-2267. doi: 10.1056/NEJMoa1107579Guyton JR, Slee AE, Anderson T, Fleg JL, Goldberg RB, Kashyap ML, Marcovina SM, Nash SD, O'Brien KD, Weintraub WS, Xu P, Zhao XQ, Boden WE. Relationship of lipoproteins to cardiovascular events in the atherothrombosis intervention in metabolic syndrome with low HDL/high triglycerides and impact on global health outcomes (AIM-HIGH) trial. J Am Coll Cardiol 2013;62(17):1580-1584. doi: 10.1016/j. jacc.2013.07.023HPS2-THRIVE Collaborative Group. HPS2-THRIVE randomized placebo-controlled trial in 25 673 high-risk patients of ER niacin/laropiprant: trial design, pre-specified muscle and liver outcomes, and reasons for stopping study treatment. Eur Heart J 2013;34(17):1279-1291)Gotoda T, Shirai K, Ohta T, Kobayashi J, Yokoyama S, Oikawa S, Bujo H, Ishibashi S, Arai H, Yamashita S, Harada-Shiba M, Eto M, Hayashi T, Sone H, Suzuki H, Yamada N; Research Committee for Primary Hyperlipidemia. Diagnosis and management of type I and type V hyperlipoproteinemia. J Atheroscler Thromb. 2012; 19 (1):1-12HPS2-THRIVE Collaborative Group. HPS2-THRIVE randomized placebo-controlled trial in 25 673 high-risk patients of ER niacin/laropiprant: trial design, pre-specified muscle and liver outcomes, and reasons for stopping study treatment. Eur Heart J 2013;34(17):1279-1291University of Oxford Clinical Trial Service Unit and Epidemiological Studies Unit. HPS2-THRIVE. http://www. ctsu.ox.ac.uk/research/mega-trials/hps2-thrive (accessed Nov 28, 2013)Huijgen R, Abbink EJ, Bruckert E, Stalenhoef AF, Imholz BP, Durrington PN, Trip MD, Eriksson M, Visseren FL, Schaefer JR, Kastelein JJ, and the Triple Study Group. Colesevelam added to combination therapy with a statin and ezetimibe in patients with familial hypercholesterolemia: a 12 week, multicenter, randomized, double-blind, controlled trial. Clin Ther 2010; 32: 615-25. doi: 10.1016/j.clintheraErik S. Stroes; Paul D. Thompson; Alberto Corsini; Georgirene D. Vladutiu; Frederick J. Raal; Kausik K. Ray; Michael Roden; Evan Stein; Lale Tokgozoglu; Borge G. Nordestgaard; Eric Bruckert; Guy De Backer; Ronald M. Krauss; Ulrich Laufs; Raul D. Santos; Robert A. Hegele; Hovingh G. Kees; Lawrence A. Leiter; Francois Mach; Winfried Marz; Connie B. Newman; Olov Wiklund; Terry A. Jacobson; Alberico L. Catapano; M. John Chapman; Henry N. Ginsberg European Atherosclerosis Society Consensus Panel; European Atherosclerosis Society Consensus Panel; Erik Stroes; Paul D. Thompson; Alberto Corsini; Georgirene D. Vladutiu; Frederick J. Raal; Kausik K. Ray; Michael Roden; Evan Stein; Lale Tokgozoglu; Borge G. Nordestgaard; Eric Bruckert; Ronald M. Krauss; Ulrich Laufs; Raul D. Santos; Winfried Marz; Connie B. Newman; M. John Chapman; Henry N. Ginsberg; M. John Chapman; Henry N. Ginsberg; Guy de Backer; Alberico L. Catapano; Robert A. Hegele; G. Kees Hovingh; Terry A. Jacobson; Lawrence Leiter; Francois Mach Olov Wiklund. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J (2015) 36 (17): 1012-1022. DOI: https://doi.org/10.1093/eurheartj/ehv043Brunzell JD, Miller NE, Alaupovic P, Hilaire R.J.St, Wang C.S, David L. hn, Bloom SR, and Lewis B. Familial chylomicronemia due to a circulating inhibitor of lipoprotein lipase activity. Journal of Lipid Research. 1983; 24 (1): 12 19Santamarina-Fojo S. The familial chylomicronemia syndrome. Endocrinology and Metabolism Clinics of North America. 1998; 27 (3):551-567Leaf DA. Chylomicronemia and the chylomicronemia syndrome: a practical approach to management. Am J Med. 2008; 121 (1): 10-2. doi: 10.1016/j.amjmedGaddi A, Cicero AF, Odoo FO, Poli AA, Paoletti R; Atherosclerosis and Metabolic Diseases Study Group. Practical guidelines for familial combined hyperlipidemia diagnosis: an up-date. Vasc Health Risk Manag. 2007; 3 (6):877-86Gotoda T, Shirai K, Ohta T, Kobayashi J, Yokoyama S, Oikawa S, Bujo H, Ishibashi S, Arai H, Yamashita S, Harada-Shiba M, Eto M, Hayashi T, Sone H, Suzuki H, Yamada N. Research Committee for Primary Hyperlipidemia. Diagnosis and management of type I and type V hyperlipoproteinemia. J Atheroscler Thromb. 2012; 19 (1):1-12