Hypertriglyceridemia 652459 220780585 2008-06-21T15:23:57Z DOI bot 6652755 Citation maintenance. You can [[WP:DOI|use this bot]] yourself! Please [[User:DOI_bot/bugs|report any bugs]]. {{Infobox_Disease | Name = {{PAGENAME}} | Image = | Caption = | DiseasesDB = 6372 | ICD10 = {{ICD10|E|78|1|e|70}}, {{ICD10|E|78|2|e|70}}, {{ICD10|E|78|3|e|70}} | ICD9 = {{ICD9|272.1}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 2921 | MeshID = D015228 | }} In [[medicine]], '''hypertriglyceridemia''' (or "Hypertriglyceridaemia") denotes high (''hyper-'') blood levels (''-emia'') of [[triglyceride]]s, the most abundant [[fat]]ty molecule in most organisms. It has been associated with [[atherosclerosis]], even in the absence of [[hypercholesterolemia]] (high [[cholesterol]] levels). It can also lead to [[pancreatitis]] in excessive concentrations. Very high triglyceride levels may also interfere with [[blood test]]s; [[hyponatremia]] may be reported spuriously (''pseudohyponatremia''). A related term is "hyperglyceridemia" or "hyperglyceridaemia", which refers to a high level of all [[glyceride]]s, including monoglycerides, diglycerides and triglycerides. ==Signs and symptoms== Modestly elevated triglyceride levels do not lead to any physical symptoms. Higher levels are associated with [[lipemia retinalis]] (white appearance of the [[retina]]), eruptive [[xanthoma]]s (small lumps in the skin, sometimes itchy). ==Causes== *[[Idiopathic]] (constitutional) *[[Obesity]] *High [[sugar]] diet *[[Diabetes mellitus]] and [[insulin resistance]] - it is one of the defined components of [[metabolic syndrome]] (along with [[central obesity]], [[hypertension]], and [[hyperglycemia]]) *Excess [[alcoholic beverage|alcohol]] intake *[[Nephrotic syndrome]] * Genetic predisposition * Certain medications (e.g. [[isotretinoin]]) * [[Hypothyroidism]] (underactive thyroid) ==Treatment== Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the [[diet (nutrition)|diet]], as well as with [[niacin]], [[fibrate]]s and [[statin]]s (three classes of drugs). Increased [[fish oil]] intake may substantially lower an individual's triglycerides.<ref>{{cite web |url=http://www.lipidsonline.org/slides/slide01.cfm?q=hypertriglyceridemia&dpg=13 |title=Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin |accessdate=2007-09-05 |format= |work=}}</ref><ref name="pmid2035283">{{cite journal |author=Terres W, Beil U, Reimann B, Tiede S, Bleifeld W |title=[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study] |language=German |journal=Zeitschrift für Kardiologie |volume=80 |issue=1 |pages=20–4 |year=1991 |pmid=2035283 |doi=}}</ref><ref>{{cite web |url=http://www.findarticles.com/p/articles/mi_m0887/is_n4_v9/ai_8960077 |title=Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles |accessdate=2007-09-05 |format= |work=}}</ref> [[Clinical practice guidelines]] by the [[National Cholesterol Education Program]] (NCEP) suggests that pharmacotherapy be considered with a triglycerides level over 200 mg/dl.<ref name="pmid11368702">{{cite journal |author= |title=Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) |journal=JAMA |volume=285 |issue=19 |pages=2486–97 |year=2001 |pmid=11368702 |doi=|url=http://jama.ama-assn.org/cgi/content/full/285/19/2486}}</ref> The guidelines state "the sum of LDL + VLDL cholesterol (termed non-HDL cholesterol [total cholesterol - HDL cholesterol]) as a secondary target of therapy in persons with high triglycerides (200 mg/dL). The goal for non-HDL cholesterol in persons with high serum triglycerides can be set at 30 mg/dL higher than that for LDL cholesterol ([http://jama.ama-assn.org/cgi/content/full/285/19/2486/TABLEJSC10094T9 Table 9]) on the premise that a VLDL cholesterol level 30 mg/dL is normal."<ref name="pmid11368702"/> ===Primary prevention=== In the [[Helsinki Heart Study]], a [[randomized controlled trial]] of asymptomatic men ages 40-55 without heart disease, 600 mg of [[gemfibrozil]] twice daily reduced cardiac endpoints at 5 years from 4.14% to 2.73%. This means that 54 patients must be treated for five years to prevent one cardiac event ([[number needed to treat]] is 54).<ref name="pmid3313041">{{cite journal |author=Frick MH, Elo O, Haapa K, ''et al'' |title=Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease |journal=N. Engl. J. Med. |volume=317 |issue=20 |pages=1237–45 |year=1987 |pmid=3313041 |doi=}}</ref> ===Secondary prevention=== In the [[Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study]] (VA-HIT), a [[randomized controlled trial]] of men with known heart disease HDL cholesterol of 40 mg/dl or less , 600 mg of gemfibrozil twice daily reduced cardiac endpoints (nonfatal myocardial infarction or death from coronary causes) at 5 years from 21.7% to 17.3%. This means that 23 patients must be treated for five years to prevent one cardiac event ([[number needed to treat]] is 23).<ref name="pmid10438259">{{cite journal |author=Rubins HB, Robins SJ, Collins D, ''et al'' |title=Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group |journal=N. Engl. J. Med. |volume=341 |issue=6 |pages=410–8 |year=1999 |pmid=10438259|doi=10.1056/NEJM199908053410604}}</ref> ==References== {{reflist|2}} {{Lipidemias}} [[Category:Cardiology]] [[Category:Lipid disorders]] [[Category:Medical conditions related to obesity]] [[fr:Hypertriglycéridémie]] [[pl:Hipertrójglicerydemia]] [[pt:Hipertrigliceridemia]]