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Hypertriglyceridemia is a common condition of elevated triglyceride levels which is often caused or contributed by uncontrolled diabetes mellitus, obesity, and sedentary habits, all of which are now prevalent in industrialized societies and in the developing nations. Hypertriglyceridemia is a risk factor for coronary artery disease (CAD).


Hypertriglyceridemia usually does not kick in symptoms until triglycerides cross the 1000-2000 mg/dL mark. The symptoms that accompany include the following:

  • Gastro-Intestinal Pain in the mid-epigastric region, chest, or the back
  • Nausea and vomiting
  • Dyspnea which is difficulty in breathing or laboured breathing
  • Xanthomas are lesions or fatty growths of cholesterol-rich material which are yellowish in color and can appear anywhere in the body
  • Corneal arcus which is an involutional change modified by genetic factors where there is a white, grey or blue opaque ring in the corneal margin (peripheral corneal opacity) or a white ring in front of the periphery of the iris
  • Xanthelasmas are minor growths, usually a sharply demarcated yellowish plaque and deposit of fat under the skin around or on the eyelids which are neither harmful nor painful but can be disfiguring


On examination, the risk factors for hypertriglyceridemia include the following:

  • Familial and genetic syndromes
  • Metabolic diseases
  • Drugs
  • Sedentary lifestyle
  • Unhealthy Diet
  • Stress
  • Lack of physical activity
  • Indiscriminate Alcohol Intake
  • Compulsive smoking
  • Uncontrolled diabetes


Laboratory studies that help evaluate hypertriglyceridemia include the following:

  • Lipid analysis
  • Chylomicron determination
  • Fasting blood glucose level
  • TSH level
  • Urinalysis
  • Liver function studies
  • Biopsy in case of an eruptive xanthomas



The first line of treatment is Nonpharmacologic management of hypertriglyceridemia which primarily involves lifestyle modifications in diet, exercise, weight reduction, smoking cessation, and limiting alcohol intake.


Medications used in the management of hypertriglyceridemia include the following:

  • Fibric acid derivatives (eg, gemfibrozil, fenofibrate)
  • Niacin (slow-release, immediate-release, extended-release formulations)
  • Omega-3 fatty acids (eg, omega-3-acid ethyl esters)
  • HMG-CoA reductase inhibitors (eg, atorvastatin, fluvastatin, pitavastatin, pravastatin, lovastatin, simvastatin, rosuvastatin)

Surgical option

Usually, surgery is not required to correct hypertriglyceridemia. Plasmapheresis is recommended in case of severe hypertriglyceridemia to reduce triglycerides in the acute setting. Ileal bypass surgery usually improves all lipid parameters but should be reserved for severe hypertriglyceridemia which is refractory.

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