Hypertriglyceridemia

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Etiology 4 Pathology 5 Complications 6 Management 7 More General Terms 8 Additional Terms 9 References

More Specific Terms

• familial hypertriglyceridemia

Introduction

• Elevated triglycerides in serum.

Etiology

• hyperlipoproteinemias I, IIb, IV, V
• diseases/disorders

• hypothyroidism
• nephrotic syndrome
• glycogen storage diseases
• diabetes mellitus

• extremely high triglyceride concentrations are common in acute pancreatitis
• non- fasting state

Pathology

• associated with low levels of HDL cholesterol & high levels of small, dense LDL particles

Complications

• uncertain independent association with: [2,3,4]

• coronary artery disease
• ischemic stroke, transient ischemic attack

• hypercoagulability [5]

Management

• non pharmacologic therapy [8]

• aerobic exercise
• weight reduction
• avoid excess alcohol
• fish oil may reduce serum triglycerides via effect on VLDL production

• pharmacologic therapy (serum triglyceride > 500 mg/dL) [10]

• fibrate

• not much benefit of fibrate with serum triglyceride < 500 mg/dL (see Field study)
• fenofibrate lowers serum triglycerides, but does not favorably affect adverse cardiovascular events [6] (see ACCORD study)
• fenofibrate may unfavorably affect GFR [6]

• nicotinic acid

• of no outcome benefit when added to statin [9]

• control of associated disorders [8]

• glycemic control in patients with diabetes mellitus
• use of statins in patients with elevated LDL

More General Terms

• hyperlipidemia

Additional Terms

• diabetes mellitus
• Field study
• glycogen storage disease (glycogenosis)
• hyperlipoproteinemia (HLP)
• hypothyroidism
• nephrotic syndrome
• pancreatitis
• triglyceride in serum

References

1. UpToDate 13.3 [1]
2. Avins AL et al Do triglycerides provide meaningful information about heart disease risk? Arch Intern Med 2000 160:1937
3. Garber AM & Avins AL, Triglyceride concentration in coronary heart disease. Not yet proved of value as a screening test. BMJ 1994; 309:2
4. Cullen P Evidence that triglycerides are an independent coronary heart disease risk factor Am J Cardiol 2000; 86:943
5. Simpson HCR et al Hypertriglyceridaemia and hypercoagulability Lancet 1983; 1:786
6. The ACCORD Study Group. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010 Apr 29;362(17):1563-74 <PubMed> PMID: [2] <Internet> [3]
7. Miller M et al Triglycerides and Cardiovascular Disease A Scientific Statement From the American Heart Association Circulation. 2011 Apr 18 <PubMed> PMID: [4] <Internet> [5]
8. Prescriber's Letter 18(6): 2011 Strategies for Lowering Triglycerides Detail-Document#: [6] (subscription needed) [7]
9. NIH News: Thursday, May 26, 2011 NIH stops clinical trial on combination cholesterol treatment Lack of efficacy in reducing cardiovascular events prompts decision [8]
10. Miller M et al. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2011 May 24 ; 123:2292 PMID: [9]

hypertriglyceridemia