Key Points
Diagnosis and Definitions
Î Severe and very severe hypertriglyceridemia increase the risk for
pancreatitis, whereas mild or moderate hypertriglyceridemia may be a
risk factor for cardiovascular disease. Therefore, similar to the National
Cholesterol Education Program Adult Treatment Panel (NCEP ATP)
III guideline committee's recommendations, the Endocrine Society
recommends screening adults for hypertriglyceridemia as part of a lipid
panel at least every 5 yr (1|⊕⊕
).
Î Base the diagnosis of hypertriglyceridemia on fasting triglyceride levels and
not on nonfasting triglyceride levels (1|⊕⊕⊕
).
Î AVOID the routine measurement of lipoprotein particle heterogeneity in
patients with hypertriglyceridemia (1|⊕⊕
). Measurement of apolipoprotein
B (apoB) or lipoprotein(a) [Lp(a)] levels can be of value, whereas measurement
of other apolipoprotein levels has little clinical value (2|⊕⊕
).
Causes of elevated triglycerides—primary and secondary
Î Evaluate individuals found to have any elevation of fasting triglycerides for
secondary causes of hyperlipidemia including endocrine conditions and
medications. Focus treatment on such secondary causes (1|⊕⊕
).
Î Assess patients with primary hypertriglyceridemia for other cardiovascular
risk factors such as central obesity, hypertension, abnormalities of glucose
metabolism, and liver dysfunction (1|⊕⊕
).
Î Evaluate patients with primary hypertriglyceridemia for family history of
dyslipidemia and cardiovascular disease to assess genetic causes and
future cardiovascular risk (1|⊕⊕
).
