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Triglycerides: Emerging Targets in Diabetes Care? Review of Moderate Hypertriglyceridemia in Diabetes

  • Anastasia-Stefania AlexopoulosEmail author
  • Ali Qamar
  • Kathryn Hutchins
  • Matthew J. Crowley
  • Bryan C. Batch
  • John R. Guyton
Macrovascular Complications in Diabetes (VR Aroda and A Getaneh, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Macrovascular Complications in Diabetes

Abstract

Purpose of Review

Moderate hypertriglyceridemia is exceedingly common in diabetes, and there is growing evidence that it contributes to residual cardiovascular risk in statin-optimized patients. Major fibrate trials yielded inconclusive results regarding the cardiovascular benefit of lowering triglycerides, although there was a signal for improvement among patients with high triglycerides and low high-density lipoprotein (HDL)—the “diabetic dyslipidemia” phenotype. Until recently, no trials have examined a priori the impact of triglyceride lowering in patients with diabetic dyslipidemia, who are likely among the highest cardiovascular-risk patients.

Recent Findings

In the recent REDUCE IT trial, omega-3 fatty acid icosapent ethyl demonstrated efficacy in lowering cardiovascular events in patients with high triglycerides, low HDL, and statin-optimized low-density lipoprotein (LDL). The ongoing PROMINENT trial is examining the impact of pemafibrate in a similar patient population.

Summary

Emerging evidence suggests that lowering triglycerides may reduce residual cardiovascular risk, especially in high-risk patients with diabetic dyslipidemia.

Keywords

Hypertriglyceridemia Type 2 diabetes Diabetic dyslipidemia Medications 

Notes

Funding Information

MJC is supported by a Career Development Award from VHA Health Services Research & Development (CDA 13-261) and acknowledges support from the Center of Innovation to Accelerate Discovery and Practice Transformation (CIN 13-410). Additionally, research reported in this publication was supported by the National Institutes of Health under Award No. T32DK007012 (ASA).

Compliance with Ethical Standards

Conflict of Interest

John R. Guyton has received research support from Sanofi, Regeneron Pharmaceuticals, and Amarin Pharmaceuticals.

Anastasia-Stefania Alexopoulos, Ali Qamar, Kathryn Hutchins, Matthew J. Crowley, Bryan C. Batch, and John R. Guyton declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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Authors and Affiliations

  • Anastasia-Stefania Alexopoulos
    • 1
    • 2
    Email author
  • Ali Qamar
    • 1
    • 2
  • Kathryn Hutchins
    • 1
    • 2
  • Matthew J. Crowley
    • 1
    • 2
  • Bryan C. Batch
    • 1
    • 2
  • John R. Guyton
    • 1
  1. 1.Department of Medicine, Division of EndocrinologyDuke University Medical CenterDurhamUSA
  2. 2.Department of Medicine, Division of EndocrinologyDurham VA Medical CenterDurhamUSA

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