Treatment approaches of hypertriglyceridemia in patients with dyslipidemia and obesity

O.D. Ostroumova^1,2, S.S. Telkova¹, A.V. Dubinina¹, E.Yu. Ebzeeva¹, M.V. Klepikova¹, A.V. Arablinsky^1,3, N.M. Doldo⁴

¹Russian Medical Academy of Continuous Professional Education, Moscow

²Central State Medical Academy of the Administrative Department of the President of the Russian Federation, Moscow

³S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center, Moscow

⁴Central Clinical Hospital "RZD-Meditsina", Moscow

The high prevalence of obesity and its associated cardiovascular diseases (CVD) constitutes a significant medical and social concern. Dyslipidemia is one of the principal risk factors in this patient cohort. Notably, beyond elevated low-density lipoprotein cholesterol (LDL-C) — the primary atherogenic factor — dyslipidemia in obese patients is typically characterized by increased serum triglyceride (TG) levels and reduced high-density lipoprotein cholesterol (HDL-C) fractions, both of which contribute to the residual risk of CVD even after LDL-C correction. Therefore, the management of dyslipidemia in obese individuals requires a comprehensive approach, including both non-pharmacological interventions and pharmacotherapy. According to clinical guidelines, statins represent the first-line drug therapy; however, available data indicate that these agents have only a modest effect on hypertriglyceridemia. Consequently, patients with obesity commonly require combination therapy, with the addition of fibrates and/or omega-3 polyunsaturated fatty acids (omega-3 PUFAs) to statins. Among fibrates, fenofibrate is the only agent recommended for concomitant use with statins. Its micronized formulation enhances bioavailability, thereby increasing its hypolipidemic efficacy and improving patient compliance. When adding omega-3 PUFAs, the use of pharmaceutical-grade preparations is advised. Both agents, according to several studies, significantly reduce TG levels, while fenofibrate also increases HDL-C concentrations, thus contributing to the prevention of cardiovascular complications in obese patients’.HDL, contributing to the prevention of cardiovascular complications in obese patients.

Keywords: dyslipidemia, obesity, hypertriglyceridemia, fenofibrate, omega-3 polyunsaturated fatty acids.

For citation: Ostroumova O.D., Telkova S.S., Dubinina A.V., Ebzeeva E.Yu., Klepikova M.V., Arablinsky A.V., Doldo N.M. Treatment approaches of hypertriglyceridemia in patients with dyslipidemia and obesity. RMJ. 2025;5:29–35. DOI: 10.32364/2225-2282-2025-5-6