What is Hypertriglyceridemia?

Triglycerides are fatty molecules composed of three fatty acids linked to a glycerol molecule and comprise up to 95% of the fats in our diet. After absorption, triglycerides are linked with protein inside the intestinal cells to form chylomicrons, which are the transport form of these molecules. Chylomicrons carry triglycerides to the cells for use as fuel and for storage in fat cells.

High triglyceride levels are associated with a set of conditions that are together referred to as the 'metabolic syndrome.' Metabolic syndrome comprises hyperglycemia, obesity in the abdominal area, hypertension, and low high-density lipoprotein (HDL), which is commonly referred to as the 'good cholesterol,' levels.

Causes

Triglycerides are used by the body as an efficient source of energy; however, excessive amounts are carried to the fat cells for storage. High triglyceride levels are associated with low HDL levels, which are a risk factor for coronary heart disease because they promote atherosclerosis.

Obesity caused by habitual overeating is one factor that can lead to high triglyceride levels in the blood in many cases. Diets that are high in carbohydrates, particularly those that involve the excessive consumption of simple sugars like fructose, are often contributors to hypertriglyceridemia as these diets dramatically increase triglyceride levels.

On the other hand, familial hypertriglyceridemia, which is caused by an autosomal dominant defect, often manifests in late puberty or early adulthood, and can therefore also cause an individual to develop this condition. Some health conditions can also lead to hypertriglyceridemia, some of which include cirrhosis or liver disease resulting in liver damage, hypothyroidism, hyperglycemia, and nephrotic syndrome.

Certain medications, such as some diuretics, testosterone and estrogen, blood pressure-lowering agents of some types, can also contribute to the development of hypertriglyceridemia.

Risk factors

The occurrence of a high triglyceride level is often associated with obesity, diabetes, and high insulin levels, which aggravate the condition. Other factors that can increase an individual's risk of hypertriglyceridemia include:

  • Alcohol abuse
  • Contraceptive agents
  • Family history of hypertriglyceridemia
  • Family history of an early heart attack before the age of 50 years
  • Hypothyroidism

Complications

High triglyceride levels cause arterial blockage, which can lead to coronary heart disease, stroke, and peripheral arterial disease. Pancreatitis can also occur if the triglyceride levels are very high. Other complications of hypertriglyceridemia include obesity and diabetes.

Diagnosis

There are no symptoms of high triglyceride levels. Therefore, the diagnosis of this condition is achieved by a blood test called the lipid profile, which is usually done after 8-12 hours of fasting. High triglyceride levels are often associated with high very-low-density lipoprotein (VLDL) levels as well.

Prevention and Treatment

There are several recommendations that can be made for individuals with or at risk of developing hypertriglyceridemia, some of which include:

  • Control certain health conditions that further increase triglyceride levels, such as alcohol use, obseity, or high blood sugar levels
  • Quit smoking.
  • One hour of physical exercise every day.
  • Dietary modifications, specifically those which reduce sugar and animal fat consumption.
  • Certain mdications, such as fibrates, niacin, or gemfibrozil, can be prescribed if triglyceride levels remain high despite lifestyle modifications.
  • Early detection by screening family members of a patient with familial hypertriglyceridemia to ensure it is treated before complications arise.

References

Further Reading

Last Updated: Mar 10, 2023

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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