Hypertriglyceridemia
DefinitionHypertriglyceridemia is an elevation of triglycer-
ide levels in the bloodstream.
OriginsHypertriglyceridemia is a condition characterized
by elevated triglyceride levels.Triglyceridesare the
chemical form in which more than 90% of dietary fat
and body fat exist. There are two sources of triglycer-
ides: they are either obtained from the diet (dietary
triglycerides) or manufactured by the body itself in the
liver. They circulate constantly with all the lipoprotein
carriers of the blood. The most important lipoproteins
are:
Very high-density lipoprotein (VHDL). VHDL con-
sists of proteins and a high concentration of free fatty
acids.
High-density lipoprotein (HDL). HDL helps remove
fat from the body by binding with it in the blood-
stream and carrying it back to the liver for excretion
in the bile and disposal. A high level of HDL may
lower chances of developing heart disease or stroke,
this is why it is called the ‘‘good cholesterol’’.
Intermediate-density lipoprotein (IDL). IDLs are
formed during the degradation of very-low-density
lipoproteins; some are cleared rapidly into the liver
and some are broken down to low-density
lipoproteins.
Low-density lipoproteins (LDL). LDL transports
cholesterol to extrahepatic tissues (outside the liver)
to other parts of the body. A high LDL level may
increase chances of developing heart disease, this is
why it is referred to as the ‘‘bad cholesterol’’.
Very low-density lipoprotein (VLDL). VLDLs carry
triglycerides from the intestine and liver to fatty
(adipose) and muscle tissues; they contain primarily
triglycerides. A high VLDL level can cause the
buildup of cholesterol in arteries and increase the
risk of heart disease and stroke.
Chylomicrons. Proteins that transport cholesterol
and triglycerides from the small intestine to tissues
after meals.
A blood cholesterol test usually reports on both
cholesterol and triglyceride levels. The American
Heart Association endorses the National Cholesterol
Education Program (NCEP), a division of the
National Institutes of Health (NIH), and its guidelines
for the detection of high cholesterol. The following are
considered normal results:
Total cholesterol (100–199 mg/dL)
LDL (less than 100 mg/dL)
HDL (40–59 mg/dL)
Triglycerides (less than 150 mg/dL)
Hypertriglyceridemia is a common disorder in the
United States. It is made worse by uncontrolleddia-
betes mellitus,obesity, cirrhosis of the liver and sed-
entary habits, all of which are more common in
industrialized countries than in developing nations.
The condition generally occurs in people who have
low proteinand high carbohydrate diets, but also
has genetic causes, not very well-defined. One inher-
ited form is ‘‘familial hypertriglyceridemia’’, affecting
about 1 out of 300 individuals in the United States.
Hypertriglyceridemia can also result from a disorder
of lipoproteinmetabolism(dyslipidemia). Triglycer-
ide levels increase gradually in men until about age 50
years and then decline slightly. In women they con-
tinue to increase with age.
In 2001, the National Cholesterol Education Pro-
gram (NCEP) released recommendations on triglyceride
levels that should determine whether hypertriglyceride-
mia treatment is required or not:
Normal: less than 150 mg/dL
Borderline: 150–199 mg/dL
High: 200–499 mg/dL
Very high: higher than 500 mg/dL
In the Fredrickson classification of hyperlipide-
mias, the general term for elevated lipids in the blood,
hypertriglyceridemia is classified as four different
types:Possible causes of Hypertriglyceridemia- Acute pancreatitis
- Certain medications
- Diabetes mellitus
- Excessive alcohol intake
- High-carbohydrate diet
- High-sugar diet
- Hypothyroidism
- Genetics
- Metabolic syndrome
- Nephrotic syndrome
- Obesity
- Pregnancy
(Illustration by GGS Information Services/Thomson Gale.)Hypertriglyceridemia