|
|
| (30 intermediate revisions by 8 users not shown) |
| Line 1: |
Line 1: |
| {{DiseaseDisorder infobox |
| | #REDIRECT[[Hyperlipoproteinemia]] |
| Name = Hypertriglyceridemia |
| |
| ICD10 = E78.1, E78.2, E78.3 |
| |
| ICD9 = {{ICD9|272.1}} |
| |
| }}
| |
| {{SI}}
| |
| | |
| {{CMG}}
| |
| | |
| ==Overview==
| |
| '''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.
| |
| | |
| ==Causes==
| |
| *[[Idiopathic]] (constitutional)
| |
| *[[Obesity]]
| |
| *High [[sugar]] diet
| |
| *[[Diabetes mellitus]] and [[insulin resistance]]
| |
| *Excess [[alcohol]] intake
| |
| *[[Metabolic syndrome]]
| |
| *[[Nephrotic syndrome]]
| |
| * Genetic predisposition
| |
| | |
| ==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 | 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 |format= |work=}}</ref>
| |
| | |
| [[Clinical practice guidelines]] by the [[National Cholesterol Education Program]] (NCEP) suggests that pharmacotherapy be considered with triglycerides are 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=}}</ref>
| |
| | |
| ==References==
| |
| {{Reflist|2}}
| |
| | |
| | |
| [[fr:Hypertriglycéridémie]]
| |
| [[pt:Hipertrigliceridemia]]
| |
| | |
| [[Category:Cardiology]]
| |
| [[Category:Lipid disorders]]
| |
| [[Category:Medical conditions related to obesity]]
| |
| | |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |