The ODYSSEY DM-DYSLIPIDEMIA trial: confirming the benefits of alirocumab in diabetic mixed dyslipidemia

The role of triglycerides in the development of atherosclerotic cardiovascular disease (ASCVD) has been a controversial issue for many years, but recent evidence from epidemiology and Mendelian randomization studies has confirmed that elevated triglycerides, and perhaps more importantly triglyceride-rich lipoproteins, are strong and independent predictors of ASCVD and all-cause mortality (1). Hypertriglyceridemia is often related to genetic factors which are typically polygenic in mild-to-moderate hypertriglyceridemia or monogenic in severe hypertriglyceridemia with triglyceride concentration >10 mmol/L (>885 mg/dL) (2). Lifestyle, other diseases and medications also influence triglyceride levels and diabetes is typically associated with elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein (LDL) particles which are small and dense resulting in atherogenic diabetic dyslipidemia (3).