High triglyceride causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Hypertriglyceridemia can occur due to various causes, including genetics, familial, metabolic and drugs

Causes

Primary hypertriglyceridemia

Genetics

Type I hyperlipoproteinemia

• Genetic deficiency or dysfunction of enzyme lipoprotein lipase (LPL)
• Deficiency of apo C-II, that acts as a cofactor of LPL
• Insulin deficiency or dysfunction in diabetes type 1 and 2 can also cause this disorder as LPL requires insulin for its full function.

Familial combined hyperlipidemia

• Autosomal dominant disorder
• Patients have either isolated triglyceride or LDL-c elevations or both.
• Family history of premature coronary artery disease in 1 or more first-degree relatives
• Family history for elevated triglycerides with or without elevated LDL-c levels.

Familial hypertriglyceridemia

• Autosomal dominant trait
• These patients and their families have isolated triglyceride elevations
• Increased risk of premature coronary artery disease.

Metabolic

• Diabetes mellitus and insulin resistance
• Obesity
• Hypothyroidism
• Nephrotic syndrome
• Renal failure

Drugs

• Diuretics (high dose thiazide or chlorthalidone)
• Beta-blockers (high doses)
• Estrogen replacement therapy
• Oral contraceptive pills (high estrogen )
• Tamoxifen
• Glucocorticoids
• Oral isotretinoin
• Antiretroviral therapy (protease inhibitors, nonnucleoside reverse transcriptase inhibitors)
• Atypical antipsychotics

Miscellaneous

• Alcohol
• Pregnancy
• Acute pancreatitis
• Nonalcoholic fatty liver disorder
• High-carbohydrate or high glycemic index
• Glycogen storage disease type 1
• Lysosomal acid lipase deficiency or Cholesteryl ester storage disease
• Paraproteinemias (e.g., hypergammaglobulinemia in macroglobulinemia, myeloma, lymphoma and lymphocytic leukemias)
• Autoimmune disorders (e.g., systemic lupus erythematosis)