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Colegio de Medicina Interna de México.

2025, Number 03

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Med Int Mex 2025; 41 (03)

Consensus of the Mexican Society of Cardiology regarding triglyceride-rich lipoproteins, metabolism, diagnosis, cardiovascular risk, and fatty liver associated with metabolic dysfunction

Pavía LAA, Cruz BI, Contreras OR, Garnica CJC, Lavalle GFJ, Cossío AJE, Rebull IJM, Elías LJI, De los Ríos MO, Zubirán SR, Díaz AA, Alcocer GMA, Rivera RJF, Gayosso GA, Téllez JS, Belén RML, Badillo VMI, Pavía AV, Parcero VJJ, Aldrete VJA, Cortés LJ, Enriquez RMS, Flores OJ

Language: Spanish
References: 82
Page: 169-197
PDF size: 1499.28 Kb.


ABSTRACT

Objective: To propose evidence-based guidelines for the diagnosis and treatment of mixed dyslipidemia, focusing on triglyceride-rich lipoproteins and its impact on lipid metabolism, epidemiology, cardiovascular risk, and non-alcoholic fatty liver disease.
Materials and Methods: Experts from the Mexican Society of Cardiology were convened to review the literature on lipid metabolism, mixed dyslipidemia, and the relationship between triglyceride-rich lipoproteins and cardiovascular risk. The association between non-alcoholic fatty liver disease and atherosclerotic cardiovascular risk was also analyzed, along with strategies for risk assessment and appropriate pharmacological treatments.
Results: The use of the Globorisk model, complemented by triglyceride and apolipoprotein B measurements, was recommended for proper cardiovascular risk assessment. Non-alcoholic fatty liver disease was identified as an independent risk factor for atherosclerotic cardiovascular diseases. Statins are the first-line treatment for lowering triglycerides and cardiovascular risk. In cases of persistent hypertriglyceridemia, the addition of fibrates or omega-3 fatty acids was suggested.
Conclusions: Proper management of mixed dyslipidemia, especially in patients with hypertriglyceridemia and non-alcoholic fatty liver disease, is crucial for reducing cardiovascular risk. Statins are the initial therapeutic option, and treatment should be personalized based on triglyceride levels, overall cardiovascular risk, and response to lifestyle modifications.


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