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Hypertriglyceridemia

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Table 1. Causes of Hypertriglyceridemia Primary hypertriglyceridemia • Familial combined hyperlipidemia • Familial hypoalphalipoproteinemia • Familial hypertriglyceridemia • Familial chylomicronemia and related disorders • Familial dysbetalipoproteinemia Primary genetic susceptibility • Metabolic syndrome • Treated type 2 diabetes Secondary hypertriglyceridemia • Excess alcohol intake • Renal disease • Drug-induced (eg, thiazides, β-blockers, estrogens, isotretinoin, corticosteroids, bile acid-binding resins, antiretroviral protease inhibitors, immunosuppressants, antipsychotics) • Liver disease • Untreated diabetes mellitus • Pregnancy • Endocrine diseases • Autoimmune disorders Table 2. Criteria Proposed for Clinical Diagnosis of Elevated Triglyceride Levels Under Fasting Conditions NCEP ATP III (3) The Endocrine Society 2010 a Normal <150 mg/dL <1.7 mmol/ liter Normal <150 mg/dL <1.7 mmol/ liter Borderline- high triglycerides 150-199 mg/dL 1.7-2.3 mmol/liter Mild HTG 150-199 mg/dL 1.7-2.3 mmol/liter High triglycerides 200-499 mg/dL 2.3-5.6 mmol/liter Moderate HTG 200-999 mg/dL 2.3-11.2 mmol/liter Very high triglycerides ≥500 mg/dL ≥5.6 mmol/ liter Severe HTG 1000-1999 mg/dL 11.2-22.4 mmol/liter Very severe HTG ≥2000 mg/dL ≥22.4 mmol/liter a e criteria developed for the present guidelines focus on the ability to assess risk for premature CVD vs. risk for pancreatitis. e designations of mild and moderate hypertriglyceridemia correspond to the range of levels predominant in risk assessment for premature CVD, and this range includes the vast majority of subjects with hypertriglyceridemia. Severe hypertriglyceridemia carries a susceptibility for intermittent increases in levels above 2000 mg/dL and subsequent risk of pancreatitis; very severe hypertriglyceridemia is indicative of risk for pancreatitis. In addition, these levels suggest different etiologies. Presence of mild or moderate hypertriglyceridemia is commonly due to a dominant underlying cause in each patient, whereas severe or very severe hypertriglyceridemia is more likely due to several contributing factors.

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