Hypertriglyceridaemia

Question 1

Define hypertriglyceridemia.

Answer 1

Hypertriglyceridaemia is defined by the National Cholesterol Education Program Adult Treatment Panel III as fasting plasma triglyceride level ≥2.3 mmol/L (≥200 mg/dL).

Question 2

Explain the aetiology/risk factors of hypertriglyceridemia.

Answer 2

Family history of hyperlipidaemia
Family history of diabetes
Overweight/obese patients
High-saturated-fat diet
High-carbohydrate diet
Insulin resistance
Liver disease
Hypothyroidism
Renal disease
Excessive alcohol consumption
HIV infection
Cystic fibrosis

Question 3

Summarise the epidemiology of hypertriglyceridemia.

Answer 3

The 90th percentile for triglyceride levels has been historically noted to be approximately 2.8 mmol/L (250 mg/dL) in the US. Because hypertriglyceridemia is related to insulin resistance, its prevalence is expected to continue to increase in industrialised countries.

Question 4

Recognise the presenting symptoms of hypertriglyceridemia. Recognise the signs of hypertriglyceridemia on physical examination.

Answer 4

Lipaemia retinalis
Eruptive xanthoma
Obesity/overweight
Diabetes
Coronary artery disease
Angina/claudication

Question 5

Identify appropriate investigations for hypertriglyceridemia and interpret the results.

Answer 5

Fasting triglycerides

Question 6

Generate a management plan for hypertriglyceridemia.

Answer 6

IV insulin + dextrose
Lifestyle modification

Question 7

Identify the possible complications of hypertriglyceridemia and its management.

Answer 7

Coronary events
Acute pancreatitis

Question 8

Summarise the prognosis for patients with hypertriglyceridemia.

Answer 8

The prognosis for patients with respect to coronary artery disease or acute pancreatitis is improved significantly with lowering of triglyceride levels to the recommended targets. This will require ongoing long-term therapy with monitoring of plasma lipids as well as side effects.