Hypertriglyceridemic pancreatitis(HTGP) accounts for up to 10% of acute pancreatitis presentations in nonpregnant individuals and is the third most common cause of acute pancreatitis after alcohol and gallstones. Ther...Hypertriglyceridemic pancreatitis(HTGP) accounts for up to 10% of acute pancreatitis presentations in nonpregnant individuals and is the third most common cause of acute pancreatitis after alcohol and gallstones. There are a number of retrospective studies and case reports that have suggested a role for apheresis and insulin infusion in the acute inpatient setting. We report a case of HTGP in a male with hyperlipoproteinemia type Ⅲ who was treated successfully with insulin and apheresis on the initial inpatient presentation followed by bi-monthly outpatient maintenance apheresis sessions for the prevention of recurrent HTGP. We also reviewed the literature for the different inpatient and outpatient management modalities of HTGP. Given that there are no guidelines or randomized clinical trials that evaluate the outpatient management of HTGP, this case report may provide insight into a possible role for outpatient apheresis maintenance therapy.展开更多
Postprandial glucose level is an independent risk factor for cardiovascular disease that exerts effects greater than glucose levels at fasting state, whereas increase in serum triglyceride level, under both fasting an...Postprandial glucose level is an independent risk factor for cardiovascular disease that exerts effects greater than glucose levels at fasting state, whereas increase in serum triglyceride level, under both fasting and postprandial conditions, contributes to the development of arteriosclerosis. Insulin resistance is a prevailing cause of abnormalities in postabsorptive excursion of blood glucose and postprandial lipid profile. Excess fat deposition renders a vicious cycle of hyperglycemia and hypertriglyceridemia in the postprandial state, and both of which are contributors to atherosclerotic change of vessels especially in patients with type 2 diabetes mellitus. Several therapeutic approaches for ameliorating each of these abnormalities have been attempted, including various antidiabetic agents or new compounds targeting lipid metabolism.展开更多
Hypertriglyceridemia （HTG） is an importantmetabolic disease and strongly associated with thedevelopment of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is aff...Hypertriglyceridemia （HTG） is an importantmetabolic disease and strongly associated with thedevelopment of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is affected by various factors andmight occur owing to the complex synergisticinteraction between the genetic background andenvironmental factors.展开更多
Men who attended a Bavarian General Medicine Practice were confidentially invented here. Two male study groups were enrolled to characterize adiposity or hypertriglyceridemia showing that these men were at baseline ri...Men who attended a Bavarian General Medicine Practice were confidentially invented here. Two male study groups were enrolled to characterize adiposity or hypertriglyceridemia showing that these men were at baseline risk for hypertension [1]. Adverse alcohol consumption mediated dysfunction of renal endothelium as shown here and before [1]. This study found that alcohol use aggravated dyslipidemia, fatty liver disease and critical fasting blood glucose of obese men predicting then late hepatorenal disorders. Overall, two male study groups showed a relevant proportion of men who reported alcohol consumption showing then critical morning urines indicating dysfunction of renal endothelium. The present report looked also at healthy men who reported positive lifestyle behaviour and at men with nonalcohol adiposity and nonalcohol hypertriglyceridemia who then showed normal morning urines indicating functional renal endothelium. Relatively young men at risk were motivated to replace adverse alcohol use by healthy liquids without alcohol and by higher quality of food.展开更多
Introduction: Hypertriglyceridemia is a frequent dyslipidemia in type 2 diabetes. We aimed to determine its prevalence, its typology, and its associated factors in newly type 2 diabetes patients in Ouagadougou. Materi...Introduction: Hypertriglyceridemia is a frequent dyslipidemia in type 2 diabetes. We aimed to determine its prevalence, its typology, and its associated factors in newly type 2 diabetes patients in Ouagadougou. Material and Method: This cross-sectional, descriptive and analytic study has been performed from May 2015 to June 2016 in the Internal medicine department in Yalgado Ouédraogo teaching hospital, Ouagadougou. An accidental sample of newly type 2 diabetes outpatients, na?ve of antidiabetics therapy was studied. A 12-hour fasting triglyceridemia was performed;hypertriglyceridemia was defined for triglyceridemia > 1.5 g/L (1.7 mmol/L). Data were analyzed with Epi info 7.1.5.0. Proportions and means were compared respectively with Khi2 or Fisher’s test and Student’s test with a significance of p Results: One hundred and three patients, i.e. 35 (34%) men and 68 (66%) women were included. The sex ratio was 0.51 and the mean age 49.3 ± 10.1 years [limits: 24 and 70]. The mean value of triglyceridemia was 1.8 ± 1.7 mmol/L [limits: 0.5 and 14.9]. Hypertriglyceridemia was reported in 32 patients (31.1%): minor (11.30 mmol/L) in one (3.1%) patients. Hypertriglyceridemia’s phenotype was commonly integrated into a mixed dyslipidemia;it was often combined with a total cholesterolemia increase and a HDL cholesterolemia decrease. In bivariate analysis, hyperglycemia was associated with severe hyperglycemia (p = 0.006) and renal failure (p = 0.03). Conclusion: Hypertriglyceridemia in type 2 diabetes is frequent and often combined with other lipids disorders. It may need an optimal care.展开更多
<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Hypertriglyceridemia in children means increased plasma fasti...<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Hypertriglyceridemia in children means increased plasma fasting Triglyceride levels above the 95</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> percentile for age and sex. For children aged 0 to 9 years, a triglyceride level greater than or equal to 100 mg/dl is considered above the 95</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> percentile. Hypertriglyceridemia can be mild to borderline high, moderate to high, very high, severe and very severe (>2000 mg/dl).</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">We present the case of a 1</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">month and </span><span style="font-family:Verdana;">3 </span><span style="font-family:Verdana;">week</span><span style="font-family:Verdana;">s </span><span style="font-family:Verdana;">old baby who presented with difficulty in breathing. </span><span style="font-family:Verdana;">It </span><span style="font-family:;" "=""><span style="font-family:Verdana;">was accidentally found to have strawberry yoghurt like blood during phlebotomy, of which upon investigation had very high triglyceride levels of >2000 mg/dl. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> 1 month and 3</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">weeks old female baby, admitted as referral from nearby health centre presenting with difficulty in breath, her blood sample was incidentally found to appear as strawberry yoghurt like. Clinically the infant had features suggestive of respiratory distress, with no other systemic abnormalities noted. Chest X</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">ray that was done had features of pneumonia. The working diagnosis on admission was Pneumonia, Electrolyte imbalance. The strawberry yoghurt like blood raised suspicions of hypertriglyceridemia. Our triglyceride levels in the infant were very high at 136 mmol/l (12,046 mg/dl).</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">The patient was treated with IV antibiotics for pneumonia, electrolytes were corrected and Rosuvastatin was started. This patient improved remarkably and was discharged with Rosuvastatin. Lipid profile was followed up for 4 consecutive months in our outpatient clinic with a drastic drop in triglyceride and cho</span><span><span style="font-family:Verdana;">lesterol. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">We report a case of infantile hypertriglyceridemia </span></span><span style="font-family:Verdana;">found accidentally during phlebotomy. Despite limited resource to evaluate further on primary cause of this condition as well as family’s poor economic status to seek further medical evaluation outside the country, this case report raises awareness on how to deal with this condition in a low resource setting. It also highlights the role of statins in the treatment of hypertriglyceridemia.</span></span>展开更多
Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man...Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man diagnosed to have hypertriglyceridemia who attended for routine screening in our diagnostic laboratory at Barasat.He was nonsmoker,non-alcoholic,had a reasonable diet with abundant fruits and vegetables,and was on regular exercise.He was not taking any lipid lowering medications.He hailed from Barasat,and was employed in Government sector in Barasat and policeman by profession.His father died at the age of 57 years in a heart attack;but his mother is healthy and now almost 62 years of age,and he has two brothers one elder and another younger to him,both are healthy.His blood pressure was normal,his body-mass index was 27,and his waist circumference was 96 cm and hip circumference was 103.His waist/hip ratio was 0.932.The Biochemical analyses were as follows- Fasting Glucose:186 mg/dL,Total Cholesterol:90 mg/dL,Triglycerides:372 mg/dL,High-density cholesterol:3.80 mg/dL,Low-density cholesterol:2.90 mg/dL,VLDL:83.20 mg/dL,Cholesterol/HDL-C ratio:23.6:1,LDL-C/HDL-C:0.07:1.This study revealed the increased prevalence of dyslipidemia to be more prevalent in 31-40 year males,suggesting that this group is at an increased risk of developing CAD leading to young infarcts.Combination lifestyle therapies i.e.,enhanced physical activity and dietary modification and therapeutic intervention would help us in the treatment and management of dyslipidemia.展开更多
BACKGROUND Hypertension,hyperglycemia and hypertriglyceridemia are chronic conditions associated with cardiometabolic diseases.Certain anthropometric indices are known to predict them.AIM To investigate the associatio...BACKGROUND Hypertension,hyperglycemia and hypertriglyceridemia are chronic conditions associated with cardiometabolic diseases.Certain anthropometric indices are known to predict them.AIM To investigate the association of anthropometric indices with these chronic diseases and which anthropometric index predicts them best.METHODS In this study,221 apparently healthy individuals who never received treatments for cardiovascular disease(CVD),diabetes or other chronic diseases participated.The age of the participants ranged from 20-75 years with mean age of 36.9±11.4 years.The risk factors of these diseases namely systolic blood pressures(SBP)and diastolic blood pressures(DBP),fasting blood glucose(FBG)and triglycerides(TG)were determined for all the participants using standard clinical procedures.The obesity anthropometric indices,waist circumference,waist-to-height ratio,waist-to-hip ratio and body mass index as well as abdominal height(AH)and body surface index were determined.The association between each of them with the risk factors were determined by the Pearson correlation method.RESULTS From the results,it was found that AH showed superiority over the rest for SBP(r=0.301,P<0.01),DBP(r=0.370,P<0.01),FBG(r=0.297,P<0.01)and TG(r=0.380,P<0.01).Using the receiver operating characteristic curves,cut-off values of AH for SBP,DBP,FBG and TG were determined to be 24.75 cm,24.75 cm,25.25 cm and 24.75 cm respectively.CONCLUSION The indices of anthropometry used in this study correlated significantly with the studied CVD risk factors,with AH emerging as the most predictive.展开更多
Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated wi...Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated with hypercholesterolemia and drug interactions. For this study, we examined a dual strategy to manage hypertriglyceridemia in HIV-infected patient taking PIs: 1) switching patients to fosamprenavir (FPV), a PI with fewer drug interactions, and 2) adding prescription fish oil (LOVAZA?), which has been shown to reduce triglycerides. Methods: This multicenter, 24-week study enrolled 36 patients virologically suppressed (HIV-1 RNA <50 copies/mL) on PI-containing therapy with screening triglyceride levels of 200 - 1200 mg/dL and LDL cholesterol levels ≤160 mg/dL. At baseline, patients were switched to ritonavir (RTV)-boosted fosamprenavir (FPV 1400 mg/RTV 100 mg QD) and any lipid-lowering agents were stopped. At Week 6, LOVAZA 4 g QD was added. Results: Five patients prematurely discontinued due to adverse events (2), non-compliance, lost-to-follow up, and protocol violation. Median triglyceride concentration was 303 mg/dL at screening, 262 mg/dL at baseline, 290 mg/dL at Week 6 (+8% from baseline), and 218 mg/dL at Week 24 (–30% from Week 6). At Week 24, 39% (12/31) of patients had triglycerides <200 mg/dL. Among patients reaching Week 24, 100% (31/31) and 90% (28/31) had HIV-1 RNA <400 and <50 copies/mL, respectively. Conclusions: In this study, a switch to FPV/RTV followed by LOVAZA decreased median triglyceride levels and modestly increased the percentage of patients with triglyceride levels <200 mg/dL while maintaining virologic suppression in HIV-infected subjects with hypertriglyceridemia. Our data suggest that baseline PI may affect the likelihood of achieving triglycerides <200 mg/dL after 18 weeks on study. A larger study would be needed to understand the relative contributions of choice of protease inhibitor and LOVAZA to triglyceride concentrations in HIV-infected patients.展开更多
Background: Adiponectin is involved in regulating both glucose and fatty acid. Associations of the known adiponectin receptors 1 (ADIPOR1) single nucleotide polymorphism (SNP) with diabetes have been demonstrated whil...Background: Adiponectin is involved in regulating both glucose and fatty acid. Associations of the known adiponectin receptors 1 (ADIPOR1) single nucleotide polymorphism (SNP) with diabetes have been demonstrated while hypertriglyceridemia is frequently associated with cerebrovascular disease (CVD) among diabetes. Triglyceride metabolism was also reported to be different between genders and estrogen was observed to interfere with adiponectin effects via ADIPOR1. It seems important to investigate whether the ADIPOR1 SNP variants may be significant determinants in triglyceride metabolism and hence be a risk of CVD in specific gender. Methods: A survey was performed on random self-reported healthy subjects aged 35 and above with their biochemical data collected. Genotyping for ADIPOR1 SNP (rs1342387) was carried out using?TaqMan Genotyping Assays. Interviews were also conducted regarding stress, adverse diet behavior and exercise. Multivariable logistic regression analyses were performed to identify the strongest contributing variables. Findings: The ADIPOR1 minor allele carrier (T/T and T/C) had significantly (p?= 0.02) higher TG mean compared to homozygous (C/C) major alleles. TG difference was significantly higher in male (p?= 0.02) with a larger difference in mean, whereas the difference disappeared among female (p?= 0.32). Multivariate logistic regression analyses were performed by defining abnormal TG based on NCEP criteria of metabolic syndrome, and when all life style variables were entered in the model with ADIPOR1, only the ADIPOR1 inmale showed significant (p?= 0.03) and very high association with abnormal TG (Exp(β) 16.31). Discussion: The findings provide sample evidence of a relation between ADIPOR1 SNP minor allele carrier and high TG concentrations in male. The association of abnormal TG and ADIPOR1 is much stronger than that compared to life style. The implications of this survey may be further extend to identifying the genetic risk of abnormal TG at young age and reduce the CVD incidence by early intervention.展开更多
Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) from fish and fish oils appear to protect against coronary heart disease: their dietary intake is in fact inversely associated with cardiovascular disease morbidity/m...Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) from fish and fish oils appear to protect against coronary heart disease: their dietary intake is in fact inversely associated with cardiovascular disease morbidity/mortality in population studies. Recent evidence suggests that at least a part of this protective effect is mediated by a relatively small but significant decrease in blood pressure (BP) level. In fact, omega-3 PUFAs exhibit wide-ranging biological actions that include regulating both vasomotor tone and renal sodium excretion, partly competing with omega-6 PUFAs for common metabolic enzymes and thereby decreasing the production of vasoconstrictor rather than vasodilator and anti-inflammatory eicosanoids. PUFAs also reduce angiotensin-converting enzyme (ACE) activity, angiotensin II formation. We retrospectively evaluated the long-term effect of a omega-3 PUFAs supplementation on the blood pressure level of 91 hypertriglyceridemic subjects with untreated normal-high blood pressure that were prescribed a 3 grams omega-3 PUFAs supplementation in order to improve their plasma lipid pattern. After 24 months of treatment, systolic blood pressure (SBP) meanly decreased by 2.6 +/- 2.5 mmHg (p = 0.001) and diastolic blood pressure (DBP) by 1.4 +/- 3.1 mmHg (p < 0.001), while basal heart rate decreased by 4.1 +/- 4.6 bpm (p < 0.001). Both SBP and DBP reduction were significantly related to the baseline SBP (p < 0.001) and DBP (p < 0.001), respectively. Diastolic blood pressure change was also inversely related to the patient’s age (p = 0.004). No significant difference was perceived in the metabolic syndrome subgroup. In our retrospective study, highly purified omega-3 PUFAs long-term supplementation is associated with a significant reduction in SBP, DBP, and basal heart rate in hypertriglyceridemic patients with normal-high blood pressure. The main determinants of the omega-3 PUFAs anti-hypertensive effect appear to be the basal blood pressure level and age. Future research will clarify if omega-3 PUFAs supplementation could improve the antihypertensive action of specific blood pressure lowering drug classes and of statins.展开更多
Although the “triglyceride paradox” states that hypertriglyceridemia is less frequent in Blacks and the risk of pancreatitis increases with severe hypertriglyceridemia, we herein report on a case of moderate hypertr...Although the “triglyceride paradox” states that hypertriglyceridemia is less frequent in Blacks and the risk of pancreatitis increases with severe hypertriglyceridemia, we herein report on a case of moderate hypertriglyceridemia revealed by an acute chest syndrome and a milky appearance serum in a 47-year-old type 2 diabetes black patient with prior history of recurrent acute pancreatitis. In addition to insulin therapy and coronary angioplasty, the combination of a statin and a fibrate resulted two months later in a substantial improvement in triglyceride levels and a normal serum appearance.展开更多
Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemia and how it can cause pancreatitis. We outline how to investigate and manage such pati...Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemia and how it can cause pancreatitis. We outline how to investigate and manage such patients. A 35 year old man presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. There was no history of alcohol consumption and biliary imaging was normal. The only relevant past medical history was that of mild hyperlipidemia, treated with diet alone. Physical exam revealed epigastric tenderness, right lateral rectus palsy, lipemia retinalis, bitemporal hemianopsia and a delay in the relaxation phase of his ankle reflexes. Subsequent laboratory investigation revealed marked hypertriglyceridemia and panhypopituarism. An enhanced CT scan of the head revealed a large suprasellar mass impinging on the optic chiasm and hypothalamus. The patient was treated supportively; thyroid replacement and lipid lowering agents were started. He underwent a successful resection of a craniopharyngioma. Post- operatively, the patient did well on hormone replacement therapy. He has had no further attacks of pancreatitis. This case highlights many of the factors involved in the regulation of triglyceride metabolism. We review the common causes of hypertriglyceridemia and the proposed mechanisms resulting in pancreatitis. The incidence and management of hypertriglyceridemia- induced pancreatitis are also discussed.展开更多
AIM: To investigate the effect of admission hypertriglyceridemia (HTG) on the episodes of severe acute pancreatitis (SAP). METHODS: One hundred and seventy-six patients with SAP were divided into HTG group (n = 45) an...AIM: To investigate the effect of admission hypertriglyceridemia (HTG) on the episodes of severe acute pancreatitis (SAP). METHODS: One hundred and seventy-six patients with SAP were divided into HTG group (n = 45) and control group (n = 131) according to admission triglyceride (TG) 5.65 mmol/L and < 5.65 mmol/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson' s score, acute physiology and chronic heath evaluation (APACHE ) score, Balthazar's computed tomography (CT) score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE score was analyzed. RESULTS: SAP patients with HTG were younger (40.8 ± 9.3 years vs 52.6 ± 13.4 years, P < 0.05) with higher etiology rate of overeating, high-fat diet (40.0% vs 14.5%, P < 0.05) and alcohol abuse (46.7% vs 23.7%, P < 0.01), incidence rate of hypocalcemia (86.7% vs 63.4%, P < 0.01) and hypoalbuminemia (84.4% vs 60.3%, P < 0.01), 24-h APACHE score (13.6 ± 5.7 vs 10.7 ± 4.6, P < 0.01) and admission serum glucose (17.7 ± 7.7 vs 13.4 ± 6.1, P < 0.01), complication rate of renal failure (51.1% vs 16.8%, P < 0.01), shock (37.9% vs 14.5%, P < 0.01) and infection (37.4% vs 18.3%, P < 0.01) and mortality (13.1% vs 9.1%, P < 0.01). Logistic regression analysis showed a positive correlation between admission TG and 24-h APACHE score (r = 0 .509, P = 0.004).CONCLUSION: The clinical features of SAP patients with HTG are largely consistent with previous studies. HTG aggravates the episodes of SAP.展开更多
The side effects of tamoxifen are generally mild, including the effect on lipoprotein metabolism. However, there are few cases of severe tamoxifen induced hypertriglyceridemia. Hypertriglyceridemia is a marked risk fa...The side effects of tamoxifen are generally mild, including the effect on lipoprotein metabolism. However, there are few cases of severe tamoxifen induced hypertriglyceridemia. Hypertriglyceridemia is a marked risk factor for acute pancreatitis and approximately 2% to 5% of cases of acute pancreatitis are related to drugs. We report on tamoxifen-induced hypertriglyceridemia and acute pancreatitis in a 40 years old woman with type 2 diabetes mellitus occurred by dexamethasone. She was treated with insulin infusion and fenofibrate, and goserelin acetate was started instead of tamoxifen after discharge from the hospital. Also, probable pathogenic hypotheses about the correlation between tamoxifen and dexamethasone induced type 2 diabetes mellitus on severe acute pancreatitis are provided. Clinicians should take care of risks of severe acute pancreatitis on using tamoxifen, especially for patients with dexamethasone induced diabetes mellitus. These individuals should undergo pre-post tamoxifen lipid screening and careful history taking of drugs, including dexamethasone.展开更多
We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipi...We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipidemia.Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels. The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis. Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist, exhibiting a relief of abdominal symptoms. As in the present cases with acute abdomen following the ingestion of fatty food, the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen, when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.展开更多
To editor:Hypertriglyceridemia is a major risk factor for cardiovascu-lar disease and acute pancreatitis.1Accordingly,during preg-nancy,the growing serum lipid levels have potentially critical implications.2,3However,...To editor:Hypertriglyceridemia is a major risk factor for cardiovascu-lar disease and acute pancreatitis.1Accordingly,during preg-nancy,the growing serum lipid levels have potentially critical implications.2,3However,the management of gestational hypertriglyceridemia is further complicated because of the lackof safety data for most of the lipid-lowering agents.展开更多
文摘Hypertriglyceridemic pancreatitis(HTGP) accounts for up to 10% of acute pancreatitis presentations in nonpregnant individuals and is the third most common cause of acute pancreatitis after alcohol and gallstones. There are a number of retrospective studies and case reports that have suggested a role for apheresis and insulin infusion in the acute inpatient setting. We report a case of HTGP in a male with hyperlipoproteinemia type Ⅲ who was treated successfully with insulin and apheresis on the initial inpatient presentation followed by bi-monthly outpatient maintenance apheresis sessions for the prevention of recurrent HTGP. We also reviewed the literature for the different inpatient and outpatient management modalities of HTGP. Given that there are no guidelines or randomized clinical trials that evaluate the outpatient management of HTGP, this case report may provide insight into a possible role for outpatient apheresis maintenance therapy.
文摘Postprandial glucose level is an independent risk factor for cardiovascular disease that exerts effects greater than glucose levels at fasting state, whereas increase in serum triglyceride level, under both fasting and postprandial conditions, contributes to the development of arteriosclerosis. Insulin resistance is a prevailing cause of abnormalities in postabsorptive excursion of blood glucose and postprandial lipid profile. Excess fat deposition renders a vicious cycle of hyperglycemia and hypertriglyceridemia in the postprandial state, and both of which are contributors to atherosclerotic change of vessels especially in patients with type 2 diabetes mellitus. Several therapeutic approaches for ameliorating each of these abnormalities have been attempted, including various antidiabetic agents or new compounds targeting lipid metabolism.
基金partially supported by grants from the National Nature Science Foundation of China[81502869]Suzhou Key technologies of prevention and control of major diseases and infectious diseases[Gwzx201506,Gwzx201605,Gwzx201706]
文摘Hypertriglyceridemia （HTG） is an importantmetabolic disease and strongly associated with thedevelopment of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is affected by various factors andmight occur owing to the complex synergisticinteraction between the genetic background andenvironmental factors.
文摘Men who attended a Bavarian General Medicine Practice were confidentially invented here. Two male study groups were enrolled to characterize adiposity or hypertriglyceridemia showing that these men were at baseline risk for hypertension [1]. Adverse alcohol consumption mediated dysfunction of renal endothelium as shown here and before [1]. This study found that alcohol use aggravated dyslipidemia, fatty liver disease and critical fasting blood glucose of obese men predicting then late hepatorenal disorders. Overall, two male study groups showed a relevant proportion of men who reported alcohol consumption showing then critical morning urines indicating dysfunction of renal endothelium. The present report looked also at healthy men who reported positive lifestyle behaviour and at men with nonalcohol adiposity and nonalcohol hypertriglyceridemia who then showed normal morning urines indicating functional renal endothelium. Relatively young men at risk were motivated to replace adverse alcohol use by healthy liquids without alcohol and by higher quality of food.
文摘Introduction: Hypertriglyceridemia is a frequent dyslipidemia in type 2 diabetes. We aimed to determine its prevalence, its typology, and its associated factors in newly type 2 diabetes patients in Ouagadougou. Material and Method: This cross-sectional, descriptive and analytic study has been performed from May 2015 to June 2016 in the Internal medicine department in Yalgado Ouédraogo teaching hospital, Ouagadougou. An accidental sample of newly type 2 diabetes outpatients, na?ve of antidiabetics therapy was studied. A 12-hour fasting triglyceridemia was performed;hypertriglyceridemia was defined for triglyceridemia > 1.5 g/L (1.7 mmol/L). Data were analyzed with Epi info 7.1.5.0. Proportions and means were compared respectively with Khi2 or Fisher’s test and Student’s test with a significance of p Results: One hundred and three patients, i.e. 35 (34%) men and 68 (66%) women were included. The sex ratio was 0.51 and the mean age 49.3 ± 10.1 years [limits: 24 and 70]. The mean value of triglyceridemia was 1.8 ± 1.7 mmol/L [limits: 0.5 and 14.9]. Hypertriglyceridemia was reported in 32 patients (31.1%): minor (11.30 mmol/L) in one (3.1%) patients. Hypertriglyceridemia’s phenotype was commonly integrated into a mixed dyslipidemia;it was often combined with a total cholesterolemia increase and a HDL cholesterolemia decrease. In bivariate analysis, hyperglycemia was associated with severe hyperglycemia (p = 0.006) and renal failure (p = 0.03). Conclusion: Hypertriglyceridemia in type 2 diabetes is frequent and often combined with other lipids disorders. It may need an optimal care.
文摘<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Hypertriglyceridemia in children means increased plasma fasting Triglyceride levels above the 95</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> percentile for age and sex. For children aged 0 to 9 years, a triglyceride level greater than or equal to 100 mg/dl is considered above the 95</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> percentile. Hypertriglyceridemia can be mild to borderline high, moderate to high, very high, severe and very severe (>2000 mg/dl).</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">We present the case of a 1</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">month and </span><span style="font-family:Verdana;">3 </span><span style="font-family:Verdana;">week</span><span style="font-family:Verdana;">s </span><span style="font-family:Verdana;">old baby who presented with difficulty in breathing. </span><span style="font-family:Verdana;">It </span><span style="font-family:;" "=""><span style="font-family:Verdana;">was accidentally found to have strawberry yoghurt like blood during phlebotomy, of which upon investigation had very high triglyceride levels of >2000 mg/dl. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> 1 month and 3</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">weeks old female baby, admitted as referral from nearby health centre presenting with difficulty in breath, her blood sample was incidentally found to appear as strawberry yoghurt like. Clinically the infant had features suggestive of respiratory distress, with no other systemic abnormalities noted. Chest X</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">ray that was done had features of pneumonia. The working diagnosis on admission was Pneumonia, Electrolyte imbalance. The strawberry yoghurt like blood raised suspicions of hypertriglyceridemia. Our triglyceride levels in the infant were very high at 136 mmol/l (12,046 mg/dl).</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">The patient was treated with IV antibiotics for pneumonia, electrolytes were corrected and Rosuvastatin was started. This patient improved remarkably and was discharged with Rosuvastatin. Lipid profile was followed up for 4 consecutive months in our outpatient clinic with a drastic drop in triglyceride and cho</span><span><span style="font-family:Verdana;">lesterol. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">We report a case of infantile hypertriglyceridemia </span></span><span style="font-family:Verdana;">found accidentally during phlebotomy. Despite limited resource to evaluate further on primary cause of this condition as well as family’s poor economic status to seek further medical evaluation outside the country, this case report raises awareness on how to deal with this condition in a low resource setting. It also highlights the role of statins in the treatment of hypertriglyceridemia.</span></span>
文摘Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man diagnosed to have hypertriglyceridemia who attended for routine screening in our diagnostic laboratory at Barasat.He was nonsmoker,non-alcoholic,had a reasonable diet with abundant fruits and vegetables,and was on regular exercise.He was not taking any lipid lowering medications.He hailed from Barasat,and was employed in Government sector in Barasat and policeman by profession.His father died at the age of 57 years in a heart attack;but his mother is healthy and now almost 62 years of age,and he has two brothers one elder and another younger to him,both are healthy.His blood pressure was normal,his body-mass index was 27,and his waist circumference was 96 cm and hip circumference was 103.His waist/hip ratio was 0.932.The Biochemical analyses were as follows- Fasting Glucose:186 mg/dL,Total Cholesterol:90 mg/dL,Triglycerides:372 mg/dL,High-density cholesterol:3.80 mg/dL,Low-density cholesterol:2.90 mg/dL,VLDL:83.20 mg/dL,Cholesterol/HDL-C ratio:23.6:1,LDL-C/HDL-C:0.07:1.This study revealed the increased prevalence of dyslipidemia to be more prevalent in 31-40 year males,suggesting that this group is at an increased risk of developing CAD leading to young infarcts.Combination lifestyle therapies i.e.,enhanced physical activity and dietary modification and therapeutic intervention would help us in the treatment and management of dyslipidemia.
文摘BACKGROUND Hypertension,hyperglycemia and hypertriglyceridemia are chronic conditions associated with cardiometabolic diseases.Certain anthropometric indices are known to predict them.AIM To investigate the association of anthropometric indices with these chronic diseases and which anthropometric index predicts them best.METHODS In this study,221 apparently healthy individuals who never received treatments for cardiovascular disease(CVD),diabetes or other chronic diseases participated.The age of the participants ranged from 20-75 years with mean age of 36.9±11.4 years.The risk factors of these diseases namely systolic blood pressures(SBP)and diastolic blood pressures(DBP),fasting blood glucose(FBG)and triglycerides(TG)were determined for all the participants using standard clinical procedures.The obesity anthropometric indices,waist circumference,waist-to-height ratio,waist-to-hip ratio and body mass index as well as abdominal height(AH)and body surface index were determined.The association between each of them with the risk factors were determined by the Pearson correlation method.RESULTS From the results,it was found that AH showed superiority over the rest for SBP(r=0.301,P<0.01),DBP(r=0.370,P<0.01),FBG(r=0.297,P<0.01)and TG(r=0.380,P<0.01).Using the receiver operating characteristic curves,cut-off values of AH for SBP,DBP,FBG and TG were determined to be 24.75 cm,24.75 cm,25.25 cm and 24.75 cm respectively.CONCLUSION The indices of anthropometry used in this study correlated significantly with the studied CVD risk factors,with AH emerging as the most predictive.
文摘Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated with hypercholesterolemia and drug interactions. For this study, we examined a dual strategy to manage hypertriglyceridemia in HIV-infected patient taking PIs: 1) switching patients to fosamprenavir (FPV), a PI with fewer drug interactions, and 2) adding prescription fish oil (LOVAZA?), which has been shown to reduce triglycerides. Methods: This multicenter, 24-week study enrolled 36 patients virologically suppressed (HIV-1 RNA <50 copies/mL) on PI-containing therapy with screening triglyceride levels of 200 - 1200 mg/dL and LDL cholesterol levels ≤160 mg/dL. At baseline, patients were switched to ritonavir (RTV)-boosted fosamprenavir (FPV 1400 mg/RTV 100 mg QD) and any lipid-lowering agents were stopped. At Week 6, LOVAZA 4 g QD was added. Results: Five patients prematurely discontinued due to adverse events (2), non-compliance, lost-to-follow up, and protocol violation. Median triglyceride concentration was 303 mg/dL at screening, 262 mg/dL at baseline, 290 mg/dL at Week 6 (+8% from baseline), and 218 mg/dL at Week 24 (–30% from Week 6). At Week 24, 39% (12/31) of patients had triglycerides <200 mg/dL. Among patients reaching Week 24, 100% (31/31) and 90% (28/31) had HIV-1 RNA <400 and <50 copies/mL, respectively. Conclusions: In this study, a switch to FPV/RTV followed by LOVAZA decreased median triglyceride levels and modestly increased the percentage of patients with triglyceride levels <200 mg/dL while maintaining virologic suppression in HIV-infected subjects with hypertriglyceridemia. Our data suggest that baseline PI may affect the likelihood of achieving triglycerides <200 mg/dL after 18 weeks on study. A larger study would be needed to understand the relative contributions of choice of protease inhibitor and LOVAZA to triglyceride concentrations in HIV-infected patients.
文摘Background: Adiponectin is involved in regulating both glucose and fatty acid. Associations of the known adiponectin receptors 1 (ADIPOR1) single nucleotide polymorphism (SNP) with diabetes have been demonstrated while hypertriglyceridemia is frequently associated with cerebrovascular disease (CVD) among diabetes. Triglyceride metabolism was also reported to be different between genders and estrogen was observed to interfere with adiponectin effects via ADIPOR1. It seems important to investigate whether the ADIPOR1 SNP variants may be significant determinants in triglyceride metabolism and hence be a risk of CVD in specific gender. Methods: A survey was performed on random self-reported healthy subjects aged 35 and above with their biochemical data collected. Genotyping for ADIPOR1 SNP (rs1342387) was carried out using?TaqMan Genotyping Assays. Interviews were also conducted regarding stress, adverse diet behavior and exercise. Multivariable logistic regression analyses were performed to identify the strongest contributing variables. Findings: The ADIPOR1 minor allele carrier (T/T and T/C) had significantly (p?= 0.02) higher TG mean compared to homozygous (C/C) major alleles. TG difference was significantly higher in male (p?= 0.02) with a larger difference in mean, whereas the difference disappeared among female (p?= 0.32). Multivariate logistic regression analyses were performed by defining abnormal TG based on NCEP criteria of metabolic syndrome, and when all life style variables were entered in the model with ADIPOR1, only the ADIPOR1 inmale showed significant (p?= 0.03) and very high association with abnormal TG (Exp(β) 16.31). Discussion: The findings provide sample evidence of a relation between ADIPOR1 SNP minor allele carrier and high TG concentrations in male. The association of abnormal TG and ADIPOR1 is much stronger than that compared to life style. The implications of this survey may be further extend to identifying the genetic risk of abnormal TG at young age and reduce the CVD incidence by early intervention.
文摘Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) from fish and fish oils appear to protect against coronary heart disease: their dietary intake is in fact inversely associated with cardiovascular disease morbidity/mortality in population studies. Recent evidence suggests that at least a part of this protective effect is mediated by a relatively small but significant decrease in blood pressure (BP) level. In fact, omega-3 PUFAs exhibit wide-ranging biological actions that include regulating both vasomotor tone and renal sodium excretion, partly competing with omega-6 PUFAs for common metabolic enzymes and thereby decreasing the production of vasoconstrictor rather than vasodilator and anti-inflammatory eicosanoids. PUFAs also reduce angiotensin-converting enzyme (ACE) activity, angiotensin II formation. We retrospectively evaluated the long-term effect of a omega-3 PUFAs supplementation on the blood pressure level of 91 hypertriglyceridemic subjects with untreated normal-high blood pressure that were prescribed a 3 grams omega-3 PUFAs supplementation in order to improve their plasma lipid pattern. After 24 months of treatment, systolic blood pressure (SBP) meanly decreased by 2.6 +/- 2.5 mmHg (p = 0.001) and diastolic blood pressure (DBP) by 1.4 +/- 3.1 mmHg (p < 0.001), while basal heart rate decreased by 4.1 +/- 4.6 bpm (p < 0.001). Both SBP and DBP reduction were significantly related to the baseline SBP (p < 0.001) and DBP (p < 0.001), respectively. Diastolic blood pressure change was also inversely related to the patient’s age (p = 0.004). No significant difference was perceived in the metabolic syndrome subgroup. In our retrospective study, highly purified omega-3 PUFAs long-term supplementation is associated with a significant reduction in SBP, DBP, and basal heart rate in hypertriglyceridemic patients with normal-high blood pressure. The main determinants of the omega-3 PUFAs anti-hypertensive effect appear to be the basal blood pressure level and age. Future research will clarify if omega-3 PUFAs supplementation could improve the antihypertensive action of specific blood pressure lowering drug classes and of statins.
文摘Although the “triglyceride paradox” states that hypertriglyceridemia is less frequent in Blacks and the risk of pancreatitis increases with severe hypertriglyceridemia, we herein report on a case of moderate hypertriglyceridemia revealed by an acute chest syndrome and a milky appearance serum in a 47-year-old type 2 diabetes black patient with prior history of recurrent acute pancreatitis. In addition to insulin therapy and coronary angioplasty, the combination of a statin and a fibrate resulted two months later in a substantial improvement in triglyceride levels and a normal serum appearance.
基金Supported by Alberta Heritage Foundation for Medical Research and Canadian Institute of Health Research
文摘Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemia and how it can cause pancreatitis. We outline how to investigate and manage such patients. A 35 year old man presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. There was no history of alcohol consumption and biliary imaging was normal. The only relevant past medical history was that of mild hyperlipidemia, treated with diet alone. Physical exam revealed epigastric tenderness, right lateral rectus palsy, lipemia retinalis, bitemporal hemianopsia and a delay in the relaxation phase of his ankle reflexes. Subsequent laboratory investigation revealed marked hypertriglyceridemia and panhypopituarism. An enhanced CT scan of the head revealed a large suprasellar mass impinging on the optic chiasm and hypothalamus. The patient was treated supportively; thyroid replacement and lipid lowering agents were started. He underwent a successful resection of a craniopharyngioma. Post- operatively, the patient did well on hormone replacement therapy. He has had no further attacks of pancreatitis. This case highlights many of the factors involved in the regulation of triglyceride metabolism. We review the common causes of hypertriglyceridemia and the proposed mechanisms resulting in pancreatitis. The incidence and management of hypertriglyceridemia- induced pancreatitis are also discussed.
基金National Natural Science Foundation of China, No. 30500684
文摘AIM: To investigate the effect of admission hypertriglyceridemia (HTG) on the episodes of severe acute pancreatitis (SAP). METHODS: One hundred and seventy-six patients with SAP were divided into HTG group (n = 45) and control group (n = 131) according to admission triglyceride (TG) 5.65 mmol/L and < 5.65 mmol/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson' s score, acute physiology and chronic heath evaluation (APACHE ) score, Balthazar's computed tomography (CT) score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE score was analyzed. RESULTS: SAP patients with HTG were younger (40.8 ± 9.3 years vs 52.6 ± 13.4 years, P < 0.05) with higher etiology rate of overeating, high-fat diet (40.0% vs 14.5%, P < 0.05) and alcohol abuse (46.7% vs 23.7%, P < 0.01), incidence rate of hypocalcemia (86.7% vs 63.4%, P < 0.01) and hypoalbuminemia (84.4% vs 60.3%, P < 0.01), 24-h APACHE score (13.6 ± 5.7 vs 10.7 ± 4.6, P < 0.01) and admission serum glucose (17.7 ± 7.7 vs 13.4 ± 6.1, P < 0.01), complication rate of renal failure (51.1% vs 16.8%, P < 0.01), shock (37.9% vs 14.5%, P < 0.01) and infection (37.4% vs 18.3%, P < 0.01) and mortality (13.1% vs 9.1%, P < 0.01). Logistic regression analysis showed a positive correlation between admission TG and 24-h APACHE score (r = 0 .509, P = 0.004).CONCLUSION: The clinical features of SAP patients with HTG are largely consistent with previous studies. HTG aggravates the episodes of SAP.
文摘The side effects of tamoxifen are generally mild, including the effect on lipoprotein metabolism. However, there are few cases of severe tamoxifen induced hypertriglyceridemia. Hypertriglyceridemia is a marked risk factor for acute pancreatitis and approximately 2% to 5% of cases of acute pancreatitis are related to drugs. We report on tamoxifen-induced hypertriglyceridemia and acute pancreatitis in a 40 years old woman with type 2 diabetes mellitus occurred by dexamethasone. She was treated with insulin infusion and fenofibrate, and goserelin acetate was started instead of tamoxifen after discharge from the hospital. Also, probable pathogenic hypotheses about the correlation between tamoxifen and dexamethasone induced type 2 diabetes mellitus on severe acute pancreatitis are provided. Clinicians should take care of risks of severe acute pancreatitis on using tamoxifen, especially for patients with dexamethasone induced diabetes mellitus. These individuals should undergo pre-post tamoxifen lipid screening and careful history taking of drugs, including dexamethasone.
文摘We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipidemia.Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels. The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis. Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist, exhibiting a relief of abdominal symptoms. As in the present cases with acute abdomen following the ingestion of fatty food, the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen, when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.
文摘To editor:Hypertriglyceridemia is a major risk factor for cardiovascu-lar disease and acute pancreatitis.1Accordingly,during preg-nancy,the growing serum lipid levels have potentially critical implications.2,3However,the management of gestational hypertriglyceridemia is further complicated because of the lackof safety data for most of the lipid-lowering agents.
