Hypertriglyceridemia is the presence of high amounts of triglycerides in the blood. Triglycerides are the most abundant fatty molecule in most organisms. Hypertriglyceridemia occurs in various physiologic conditions and in various diseases, and high triglyceride levels are associated with atherosclerosis, even in the absence of hypercholesterolemia (high cholesterol levels) and predispose to cardiovascular disease.

Chronically elevated serum triglyceride levels are a component of metabolic syndrome and metabolic dysfunction-associated steatotic liver disease, both of which typically involve obesity and contribute significantly to cardiovascular mortality in industrialised countries as of 2021. Extreme triglyceride levels also increase the risk of acute pancreatitis.

Hypertriglyceridemia itself is usually symptomless, although high levels may be associated with skin lesions known as xanthomas. Familial dysbetalipoproteinemia causes larger, tuberous xanthomas; these are red or orange and occur on the elbows and knees. Palmar crease xanthomas may also occur. Hypertriglyceridemia is associated with 1–4% of all cases of pancreatitis. The symptoms are similar to pancreatitis secondary to other causes, although the presence of xanthomas or risk factors for hypertriglyceridemia may offer clues.

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Diagnosis

The diagnosis is made on blood tests, often performed as part of screening. The normal triglyceride level is less than 150 mg/dL (1.7 mmol/L). Once diagnosed, other blood tests are usually required to determine whether the raised triglyceride level is caused by other underlying disorders ("secondary hypertriglyceridemia") or whether no such underlying cause exists ("primary hypertriglyceridaemia"). There is a hereditary predisposition to both primary and secondary hypertriglyceridemia.

{| class="wikitable"

! colspan="2" |Level

! rowspan="2" |Interpretation

|-

!(mg/dL)

!(mmol/L)

|-

|<&nbsp;150

|<&nbsp;1.70

|Normal range&nbsp;– low risk

|-

|150–199

|1.70–2.25

|Slightly above normal

|-

|200–499

|2.26–5.65

|Some risk

|-

|500 or higher

|>&nbsp;5.65

|Very high&nbsp;– high risk

|}

These levels are tested after fasting 8 to 12 hours. Triglyceride levels remain temporarily higher for a period after eating.

The AHA recommends an optimal triglyceride level of 100mg/dL (1.1mmol/L) or lower to improve heart health.

Screening

In 2016, the United States Preventive Services Task Force concluded that testing the general population under the age of 40 without symptoms is of unclear benefit.

Treatment

Lifestyle changes including weight loss, exercise and dietary modification may improve hypertriglyceridemia. This may include dietary changes such as restriction of fat and carbohydrates (specifically fructose and sugar-sweetened beverages

The decision to treat hypertriglyceridemia with medication depends on the levels and on the presence of other risk factors for cardiovascular disease. Very high levels that would increase the risk of pancreatitis is treated with a drug from the fibrate class. Niacin and omega-3 fatty acids as well as drugs from the statin class may be used in conjunction, with statins being the main drug treatment for moderate hypertriglyceridemia where reduction of cardiovascular risk is required. Epanova (omega-3-carboxylic acids) is another prescription drug used to treat very high levels of blood triglycerides.

Epidemiology

As of 2006, the prevalence of hypertriglyceridemia in the United States was 30%.

Etymology

The word hypertriglyceridemia uses combining forms of hyper- + triglyceride + -emia, thus corresponding to "high triglyceride levels in the blood" or "too many triglycerides in the blood".

See also

  • Remnant cholesterol

References

  • Lowering Triglycerides (EMedicineHealth.com; October 2020)

ja:脂質異常症#高トリグリセリド血症