| What Are the Causes of Increased Triglycerides? |
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Friday, 02 January 2009 19:11
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What are the causes of increased triglycerides?
The definition of hypertriglyceridemia has changed in the last decade as our understanding of the importance of high triglycerides and atherogenic remnant lipoproteins in the development of coronary heart disease and other atherosclerotic diseases has evolved. As shown in the Table ,[1] triglyceride levels of 150 mg/dL and above are considered abnormal. Elevations in triglycerides can be caused by an inherited disorder, another health condition, adverse effects of medications, or a combination of these factors. In day-to-day practice, secondary causes of high triglycerides are far more common than inherited disorders. The Table , adapted from the Adult Treatment Panel III guidelines, summarizes typical causes of high triglycerides at varying degrees of triglyceride elevation.[1,2] Among the genetic causes, familial combined hyperlipidemia and familial dysbetalipoproteinemia are clearly associated with increased coronary heart disease risk. Patients with familial hypertriglyceridemia, even though often insulin resistant, seem to carry a somewhat lower coronary heart disease risk than patients with familial combined hyperlipidemia or familial dysbetalipoproteinemia.[1,2] Patients with very high triglycerides as a result of lipoprotein lipase deficiency or apolipoprotein CII deficiency are not at high risk for coronary heart disease, but their triglyceride levels must be controlled to prevent pancreatitis.[1,2] The most common acquired causes of high triglycerides are obesity and physical inactivity. Because hypertriglyceridemia is a component of the metabolic syndrome, the presence of high triglycerides should trigger a search for concomitant risk factors such as hypertension, abnormal glucose metabolism (including frank diabetes), abdominal obesity, and low high-density lipoprotein cholesterol levels.[1] A careful diet history should exclude high carbohydrate intake and excess alcohol consumption, and clinicians should think about the possibility of underlying nephrotic syndrome, chronic kidney disease, Cushing's syndrome, and hypothyroidism.[2] All medications should be reviewed and, if possible, medications that contribute to high triglycerides should be discontinued and replaced with agents not known to increase triglyceride levels. This activity is supported by an independent educational grant from GlaxoSmithKline. http://www.medscape.com/viewarticle/585389?src=mp&spon=17&uac=117179DZ Add this page to your favourite Social Bookmarking websites;         
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