Hypertriglyceridemia refers to an elevated level of triglycerides (a type of lipid) in the bloodstream, a condition that increases the risk of coronary artery disease.
The triglycerides found in our bloodstream are a mixture of triglycerides that have been obtained from the diet and those produced in the body to provide an energy source. Hypertriglyceridemia is often caused or worsened by factors such as obesity, poorly controlled diabetes and a sedentary lifestyle.
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A certain amount of triglycerides is required in the blood to serve as a source of energy, but when there is an excess, these fats increase the risk of heart disease, stroke and other health issues. Triglycerides themselves do not directly cause the fatty deposits that accumulate in atherosclerosis, but the cholesterol inside triglyceride-rich particles called very low-density lipoproteins (VLDLs) may add to the formation of plaques. In many cases, people with hypertriglyceridemia have other lipid disorders or risk factors associated with heart disease and stroke, including obesity and metabolic syndrome. Metabolic syndrome refers to a cluster of risk factors that includes high blood pressure, high triglycerides, high blood sugar, excess fat around the waist and abnormal cholesterol levels.
After people eat, the body turns any calories that have not been used up into triglycerides and these are stored in fat cells. In between meals, certain hormones release triglycerides for energy and if people regularly consume more calories than they need to use up, they may develop a high blood triglyceride level. Whether or not a person’s triglyceride level falls within a healthy range can be ascertained using a simple blood test. A triglyceride level is considered normal if it is below 150 mg/dL, while borderline ranges from 150 to 199 mg/dL, high from 200 to 499 mg/dL and very high is 500 mg/dL or above.
As well as hypertriglyceridemia affecting the heart and blood vessels, it also increases the risk of pancreatitis or inflammation of the pancreas, the gland that produces insulin to control the blood glucose level. Pancreatitis can cause problems with digestion, stomach pain, pancreatic damage and eventually, diabetes.
The level of triglycerides in our blood usually increases with age, but risk factors that increase the likelihood of the triglyceride level becoming too high include the following:
- Overweight or obesity
- Excess alcohol intake
- Lack of physical activity
- Inherited disorders
- Type 2 diabetes
- Metabolic syndrome
- Thiazide diuretics
- Protease inhibitors for HIV
- Some cholesterol-lowering drugs
- Estrogen therapy
- Isotretinoin for acne
- Some antipsychotics
The most common reasons for hypertriglyceridemia developing are obesity, lack of physical activity, type 2 diabetes, metabolic syndrome and familial hyperlipidemia, a genetic condition that causes high triglycerides and low levels of the “good” cholesterol, HDL (high-density lipoprotein).
Hypertriglyceridemia is often accompanied by low HDL levels. This is because when VLDL give up their triglycerides, they also give up cholesterol to HDL. If triglycerides are being cleared from the blood less quickly, however, HDL receives less cholesterol, meaning the HDL cholesterol remains low and the blood cholesterol level remains high. If the triglyceride level is high, a doctor may go on to look for and treat other conditions associated with hypertriglyceridemia such as hypothyroidism, kidney disease, diabetes and metabolic syndrome.
Hypertriglyceridemia does not usually present with symptoms until the level reaches 1000 to 2000 mg/dL, at which point the signs and symptoms may include:
- Gastrointestinal pain
- Difficulty breathing
- Memory loss
- Xanthelasmas - yellowish deposits of fat on or around the eyelids
- Corneal arcus - a thin, whitish or grey arc around the outer part of the cornea
- Xanthomas - yellowish deposits of fat under the skin found on the back, chest, buttocks or proximal extremities.
In rare cases, people with a very high triglyceride level develop pancreatitis which causes severe abdominal pain, nausea, vomiting, fever and loss of appetite.