BACKGROUND Hypertriglyceridemia thalassemia syndrome is a rare condition that occurs in patients with thalassemia.It typically presents with a combination of profound anemia and milky serum.Although previous case seri...BACKGROUND Hypertriglyceridemia thalassemia syndrome is a rare condition that occurs in patients with thalassemia.It typically presents with a combination of profound anemia and milky serum.Although previous case series have demonstrated the benefit of blood transfusions in reducing serum triglycerides,information regar-ding clinical outcomes and standard management in this setting remains limited.AIM To identify the clinical course,treatment strategies,and outcomes of patients with hypertriglyceridemia thalassemia syndrome.METHODS We performed a comprehensive search of the Scopus,PubMed,and Embase databases.We included only English-language articles and did not apply any publication date limits.The databases were last accessed on September 1,2024.This study was registered under number CRD420250587918 and included studies involving children and adults with thalassemia,hypertriglyceridemia,and available data on clinical course.RESULTS A total of 14 publications were included in the analysis,all of which were case reports or case series.No higher-quality evidence was available.Among 28 children with hypertriglyceridemia thalassemia syndrome,there were 22 cases ofβ-thalassemia major and 6 cases of hemoglobin E/β-thalassemia,including our illustrative case.The median age of onset was 11 months,and 92.3%of cases presented prior to the first blood transfusion.The common clinical manifestations included pallor(100%)and hepatosplenomegaly(67.9%).For hypertriglyceridemia-related symptoms,lipemia retinalis and xanthomas were observed in 25.0%and 10.7%of cases,respectively.The median hemoglobin level was 5.5 g/dL,while the median triglyceride level was 935 mg/dL.For management,92.9%of cases received blood transfusions with or without other interventions.At a median of 12 months’follow-up,all patients responded to the treatment without lipid-lowering agents,and 85.7%of cases were alive.CONCLUSION Hypertriglyceridemia thalassemia syndrome occurs exclusively in young children and usually presents with anemia and severe hypertriglyceridemia prior to the first transfusion.Management with blood transfusions provides a favorable response.However,long-term regular monitoring is warranted.展开更多
BACKGROUND Xanthomatosis,a metabolic disorder causing yellow growths(xanthomas),poses challenges in lipid metabolism.This case study introduces the first documented instance within China's Yi population,emphasizin...BACKGROUND Xanthomatosis,a metabolic disorder causing yellow growths(xanthomas),poses challenges in lipid metabolism.This case study introduces the first documented instance within China's Yi population,emphasizing the need to explore dietary habits and treatment strategies tailored to this specific community.CASE SUMMARY Xanthomatosis is a metabolic disorder where lipid metabolism goes awry,resulting in the development of yellowish growths called xanthomas.A male patient,47 years of age,from China's Yi population,who is obese,visited our dermatology clinic complaining of widespread,non-painful rashes that have been present for two weeks.The patient works as a chef and has a diet that frequently includes oily and greasy foods.This case represents the initial documentation of xanthomatosis within the Yi population in China,offering a theoretical foundation for understanding dietary patterns and treatment options specific to the Yi community.CONCLUSION The first report of xanthomatosis in the Yi population in China lays a theoretical foundation for understanding Yi dietary patterns and treatment.展开更多
BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases.We categorize acute p...BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases.We categorize acute pancreatitis by etiology into acute biliary pancreatitis(ABP)and hypertriglyceridemia-induced acute pancreatitis(HTGP).AIM To investigate the clinical significance of NLR and PLR in assessing persistent organ failure(POF)in HTGP and ABP.METHODS A total of 1450 patients diagnosed with acute pancreatitis(AP)for the first time at Shanxi Bethune Hospital between January 2012 and January 2023 were enrolled.The patients were categorized into two groups according to the etiology of AP:ABP in 530 patients and HTGP in 241 patients.We collected and compared the clinical data of the patients,including NLR,PLR,and AP prognostic scoring systems,within 48 h of hospital admission.RESULTS The NLR(9.1 vs 6.9,P<0.001)and PLR(203.1 vs 160.5,P<0.001)were significantly higher in the ABP group than in the HTGP group.In the HTGP group,both NLR and PLR were significantly increased in patients with severe AP and those with a SOFA score≥3.Likewise,in the ABP group,NLR and PLR were significantly elevated in patients with severe AP,modified computed tomography severity index score≥4,Japanese Severity Score≥3,and modified Marshall score≥2.Moreover,NLR and PLR showed predictive value for the development of POF in both the ABP and HTGP groups.CONCLUSION NLR and PLR vary between ABP and HTGP,are strongly associated with AP prognostic scoring systems,and have predictive potential for the occurrence of POF in both ABP and HTGP.展开更多
Hypertriglyceridemia(HTG)often accompanies diabetes and is considered a risk factor for diabetic vascular complications.However,inducing diabetic HTG typically requires high-fat diets in certain animal models.Leveragi...Hypertriglyceridemia(HTG)often accompanies diabetes and is considered a risk factor for diabetic vascular complications.However,inducing diabetic HTG typically requires high-fat diets in certain animal models.Leveraging our newly developed LDL receptor knockout hamster model,which exhibits features akin to human lipid metabolism,we sought to determine whether these animals would develop HTG without dietary manipulations in diabetes.Diabetes was induced via intraperitoneal injection of STZ in wild type and heterozygous LDL receptor deficient hamsters.Blood glucose,triglyceride,and cholesterol were measured over 60 days.Plasma TG clearance was determined via olive oil gavage.The effect of insulin on diabetic HTG was assessed on Day 60 post-diabetes induction.Blood glucose increased over threefold,while plasma insulin decreased to 30%of controls after STZ injection in both wild type and heterozygous hamsters by Day 7,remaining stable for 60 days.Plasma TG in wild-type hamsters remained unchanged at Day 7 post-STZ injection but increased slightly thereafter.Conversely,heterozygous hamsters exhibited severe HTG by Day 7 until the end of the study.Olive oil gavage revealed much slower plasma triglyceride clearance in heterozygous hamsters compared to WT animals,despite significantly reduced lipoprotein lipase activity in post-heparin plasma in both animals.Hyperglycemia and HTG in heterozygous hamsters were reversed to pre-diabetic levels following intraperitoneal insulin administration.In conclusion,severe HTG in diabetic heterozygous LDL receptor deficient hamsters developed spontaneously and was insulin-dependent.Thus,this hamster model holds promise for effectively studying the complications associated with human diabetic HTG.展开更多
Background: Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. It can lead to complications such as hypertriglyceridemia-induced pancreati...Background: Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. It can lead to complications such as hypertriglyceridemia-induced pancreatitis due to increased lipolysis and triglyceride formation. Case Presentations: A 28-year-old female presented with symptoms consistent with diabetic ketoacidosis (DKA), including polyuria, polydipsia, polyphagia, and unintentional weight loss. Laboratory results revealed severe hyperglycemia (glucose 22.9 mmol/L, HbA1c 14.5%), metabolic acidosis (pH 7.15), and elevated beta-hydroxybutyrate (6.75 mmol/L). Further evaluation showed markedly elevated triglycerides (45 mmol/L) and lipase (2928 IU/L), indicating mild pancreatitis. Upon reviewing her clinical presentation and lab findings, poorly controlled diabetes was determined to be the primary cause, leading to DKA and secondary hypertriglyceridemia. The patient was managed in the ICU with insulin therapy, fluid resuscitation, and Fenofibrate to address hypertriglyceridemia. Identifying the primary precipitant through this comprehensive assessment is crucial for directing management toward aggressive control of hyperglycemia, ketosis, and triglyceride levels. Conclusions: This case underscores the complex interplay between DKA, hypertriglyceridemia, and pancreatitis. Accurate clinical evaluation is essential to tailor management strategies focusing on aggressive control of hyperglycemia and triglyceride levels to prevent complications and optimize patient outcomes.展开更多
Background: Acute pancreatitis (AP) is an extensive inflammation condition that may lead to local and systemic complications, ranging from mild edematous peripancreatic fluid collection to multiorgan failure and death...Background: Acute pancreatitis (AP) is an extensive inflammation condition that may lead to local and systemic complications, ranging from mild edematous peripancreatic fluid collection to multiorgan failure and death. Aim: To report the case of the patient with the complications that happened and the presented management. Case presentation: A 37-year-old female patient presented with acute necrotizing pancreatitis secondary to hypertriglyceridemia. During hospitalization, the patient developed severe ileus with splenic vein thrombosis. She was treated conservatively with Intravenous (IV) fluids, insulin infusion, anticoagulant, pain relief medication and antibiotics. Discussion: This case of pancreatitis induced splenic vein thrombosis (PIVST) was treated supportively with outstanding improvement of the patient’s symptoms. Conclusion: Acute pancreatitis can be complicated by splenic vein thrombosis that can be self-limited and treated with conservative measures.展开更多
Objective： To investigate the association between the mutations in lipoprotein lipase gene and hypertriglyceridemia （HTG）. Methods： The lipoprotein lipase （LPL） gene was screened for mutations in 386 Chinese sub...Objective： To investigate the association between the mutations in lipoprotein lipase gene and hypertriglyceridemia （HTG）. Methods： The lipoprotein lipase （LPL） gene was screened for mutations in 386 Chinese subjects with （108 cases in the HTG group） or without HTG （278 cases in the control group）, by single-strand conformation polymorphism （SSCP） analysis and DNA sequencing. Results： One novel silent mutation L103L, one missense mutation P207L, three splicing mutations Int3/3＇ -ass/C（-6）→T, and the common S447X polymorphism has been identified in the whole coding region and exon-intron junctions of the LPL gene were examined. Heterozygous P207L found in the HTG group was the first case reported in Asia and subsequently another P207L heterozygote was found in the proband＇s family, all of which suggested that P207L was one of the causes of familial combined hyperlipidemia, but was not so prevalent as that in French Canadian. Int3/3＇-ass/C（-6）→T was found in both groups in the present study although it was regarded as a pathogenic variant to HTG earlier on. Moreover about the beneficial polymorphism S447X, there was also some supportive evidence that the levels of triglycerides （TG） in S447X carriers were significantly lower than noncarders in the subjects without HTG. Conclusions： The association between the LPL variants and HTG is quite complicated and versatile, genotyping of LPL in a larger-scale screening should be necessary and justifiable.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 =...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 retool/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson＇ s score, acute physiology and chronic heath evaluation Ⅱ （APACHE Ⅱ） score, Balthazar＇s computed tomography （CT） score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE Ⅱ 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 Ⅱ 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 Ⅱ 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
Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemJa 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 hypertriglyceridemJa 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. Postoperatively, 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 hypertriglyceridemiainduced pancreatitis are also discussed.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
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
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 hyperlip...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
Hypertriglyceridemia （HTG） is an important metabolic disease and strongly associated with the development of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is a...Hypertriglyceridemia （HTG） is an important metabolic disease and strongly associated with the development of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is affected by various factors and might occur owing to the complex synergistic interaction between the genetic background and environmental 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
文摘BACKGROUND Hypertriglyceridemia thalassemia syndrome is a rare condition that occurs in patients with thalassemia.It typically presents with a combination of profound anemia and milky serum.Although previous case series have demonstrated the benefit of blood transfusions in reducing serum triglycerides,information regar-ding clinical outcomes and standard management in this setting remains limited.AIM To identify the clinical course,treatment strategies,and outcomes of patients with hypertriglyceridemia thalassemia syndrome.METHODS We performed a comprehensive search of the Scopus,PubMed,and Embase databases.We included only English-language articles and did not apply any publication date limits.The databases were last accessed on September 1,2024.This study was registered under number CRD420250587918 and included studies involving children and adults with thalassemia,hypertriglyceridemia,and available data on clinical course.RESULTS A total of 14 publications were included in the analysis,all of which were case reports or case series.No higher-quality evidence was available.Among 28 children with hypertriglyceridemia thalassemia syndrome,there were 22 cases ofβ-thalassemia major and 6 cases of hemoglobin E/β-thalassemia,including our illustrative case.The median age of onset was 11 months,and 92.3%of cases presented prior to the first blood transfusion.The common clinical manifestations included pallor(100%)and hepatosplenomegaly(67.9%).For hypertriglyceridemia-related symptoms,lipemia retinalis and xanthomas were observed in 25.0%and 10.7%of cases,respectively.The median hemoglobin level was 5.5 g/dL,while the median triglyceride level was 935 mg/dL.For management,92.9%of cases received blood transfusions with or without other interventions.At a median of 12 months’follow-up,all patients responded to the treatment without lipid-lowering agents,and 85.7%of cases were alive.CONCLUSION Hypertriglyceridemia thalassemia syndrome occurs exclusively in young children and usually presents with anemia and severe hypertriglyceridemia prior to the first transfusion.Management with blood transfusions provides a favorable response.However,long-term regular monitoring is warranted.
文摘BACKGROUND Xanthomatosis,a metabolic disorder causing yellow growths(xanthomas),poses challenges in lipid metabolism.This case study introduces the first documented instance within China's Yi population,emphasizing the need to explore dietary habits and treatment strategies tailored to this specific community.CASE SUMMARY Xanthomatosis is a metabolic disorder where lipid metabolism goes awry,resulting in the development of yellowish growths called xanthomas.A male patient,47 years of age,from China's Yi population,who is obese,visited our dermatology clinic complaining of widespread,non-painful rashes that have been present for two weeks.The patient works as a chef and has a diet that frequently includes oily and greasy foods.This case represents the initial documentation of xanthomatosis within the Yi population in China,offering a theoretical foundation for understanding dietary patterns and treatment options specific to the Yi community.CONCLUSION The first report of xanthomatosis in the Yi population in China lays a theoretical foundation for understanding Yi dietary patterns and treatment.
基金Supported by Shanxi Province“136”Revitalization Medical Project Construction Funds,No.2019XY004.
文摘BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases.We categorize acute pancreatitis by etiology into acute biliary pancreatitis(ABP)and hypertriglyceridemia-induced acute pancreatitis(HTGP).AIM To investigate the clinical significance of NLR and PLR in assessing persistent organ failure(POF)in HTGP and ABP.METHODS A total of 1450 patients diagnosed with acute pancreatitis(AP)for the first time at Shanxi Bethune Hospital between January 2012 and January 2023 were enrolled.The patients were categorized into two groups according to the etiology of AP:ABP in 530 patients and HTGP in 241 patients.We collected and compared the clinical data of the patients,including NLR,PLR,and AP prognostic scoring systems,within 48 h of hospital admission.RESULTS The NLR(9.1 vs 6.9,P<0.001)and PLR(203.1 vs 160.5,P<0.001)were significantly higher in the ABP group than in the HTGP group.In the HTGP group,both NLR and PLR were significantly increased in patients with severe AP and those with a SOFA score≥3.Likewise,in the ABP group,NLR and PLR were significantly elevated in patients with severe AP,modified computed tomography severity index score≥4,Japanese Severity Score≥3,and modified Marshall score≥2.Moreover,NLR and PLR showed predictive value for the development of POF in both the ABP and HTGP groups.CONCLUSION NLR and PLR vary between ABP and HTGP,are strongly associated with AP prognostic scoring systems,and have predictive potential for the occurrence of POF in both ABP and HTGP.
基金National Natural Science Foundation of China (NSFC)31520103909 and.91739105 to G.Liu,81770449 to Y.Wang。
文摘Hypertriglyceridemia(HTG)often accompanies diabetes and is considered a risk factor for diabetic vascular complications.However,inducing diabetic HTG typically requires high-fat diets in certain animal models.Leveraging our newly developed LDL receptor knockout hamster model,which exhibits features akin to human lipid metabolism,we sought to determine whether these animals would develop HTG without dietary manipulations in diabetes.Diabetes was induced via intraperitoneal injection of STZ in wild type and heterozygous LDL receptor deficient hamsters.Blood glucose,triglyceride,and cholesterol were measured over 60 days.Plasma TG clearance was determined via olive oil gavage.The effect of insulin on diabetic HTG was assessed on Day 60 post-diabetes induction.Blood glucose increased over threefold,while plasma insulin decreased to 30%of controls after STZ injection in both wild type and heterozygous hamsters by Day 7,remaining stable for 60 days.Plasma TG in wild-type hamsters remained unchanged at Day 7 post-STZ injection but increased slightly thereafter.Conversely,heterozygous hamsters exhibited severe HTG by Day 7 until the end of the study.Olive oil gavage revealed much slower plasma triglyceride clearance in heterozygous hamsters compared to WT animals,despite significantly reduced lipoprotein lipase activity in post-heparin plasma in both animals.Hyperglycemia and HTG in heterozygous hamsters were reversed to pre-diabetic levels following intraperitoneal insulin administration.In conclusion,severe HTG in diabetic heterozygous LDL receptor deficient hamsters developed spontaneously and was insulin-dependent.Thus,this hamster model holds promise for effectively studying the complications associated with human diabetic HTG.
文摘Background: Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. It can lead to complications such as hypertriglyceridemia-induced pancreatitis due to increased lipolysis and triglyceride formation. Case Presentations: A 28-year-old female presented with symptoms consistent with diabetic ketoacidosis (DKA), including polyuria, polydipsia, polyphagia, and unintentional weight loss. Laboratory results revealed severe hyperglycemia (glucose 22.9 mmol/L, HbA1c 14.5%), metabolic acidosis (pH 7.15), and elevated beta-hydroxybutyrate (6.75 mmol/L). Further evaluation showed markedly elevated triglycerides (45 mmol/L) and lipase (2928 IU/L), indicating mild pancreatitis. Upon reviewing her clinical presentation and lab findings, poorly controlled diabetes was determined to be the primary cause, leading to DKA and secondary hypertriglyceridemia. The patient was managed in the ICU with insulin therapy, fluid resuscitation, and Fenofibrate to address hypertriglyceridemia. Identifying the primary precipitant through this comprehensive assessment is crucial for directing management toward aggressive control of hyperglycemia, ketosis, and triglyceride levels. Conclusions: This case underscores the complex interplay between DKA, hypertriglyceridemia, and pancreatitis. Accurate clinical evaluation is essential to tailor management strategies focusing on aggressive control of hyperglycemia and triglyceride levels to prevent complications and optimize patient outcomes.
文摘Background: Acute pancreatitis (AP) is an extensive inflammation condition that may lead to local and systemic complications, ranging from mild edematous peripancreatic fluid collection to multiorgan failure and death. Aim: To report the case of the patient with the complications that happened and the presented management. Case presentation: A 37-year-old female patient presented with acute necrotizing pancreatitis secondary to hypertriglyceridemia. During hospitalization, the patient developed severe ileus with splenic vein thrombosis. She was treated conservatively with Intravenous (IV) fluids, insulin infusion, anticoagulant, pain relief medication and antibiotics. Discussion: This case of pancreatitis induced splenic vein thrombosis (PIVST) was treated supportively with outstanding improvement of the patient’s symptoms. Conclusion: Acute pancreatitis can be complicated by splenic vein thrombosis that can be self-limited and treated with conservative measures.
基金This work was supported by the Grant from Tianjin Municipal Natural Science Foundations (No. 033607311).
文摘Objective： To investigate the association between the mutations in lipoprotein lipase gene and hypertriglyceridemia （HTG）. Methods： The lipoprotein lipase （LPL） gene was screened for mutations in 386 Chinese subjects with （108 cases in the HTG group） or without HTG （278 cases in the control group）, by single-strand conformation polymorphism （SSCP） analysis and DNA sequencing. Results： One novel silent mutation L103L, one missense mutation P207L, three splicing mutations Int3/3＇ -ass/C（-6）→T, and the common S447X polymorphism has been identified in the whole coding region and exon-intron junctions of the LPL gene were examined. Heterozygous P207L found in the HTG group was the first case reported in Asia and subsequently another P207L heterozygote was found in the proband＇s family, all of which suggested that P207L was one of the causes of familial combined hyperlipidemia, but was not so prevalent as that in French Canadian. Int3/3＇-ass/C（-6）→T was found in both groups in the present study although it was regarded as a pathogenic variant to HTG earlier on. Moreover about the beneficial polymorphism S447X, there was also some supportive evidence that the levels of triglycerides （TG） in S447X carriers were significantly lower than noncarders in the subjects without HTG. Conclusions： The association between the LPL variants and HTG is quite complicated and versatile, genotyping of LPL in a larger-scale screening should be necessary and justifiable.
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 retool/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson＇ s score, acute physiology and chronic heath evaluation Ⅱ （APACHE Ⅱ） score, Balthazar＇s computed tomography （CT） score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE Ⅱ 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 Ⅱ 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 Ⅱ 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.
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 hypertriglyceridemJa 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. Postoperatively, 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 hypertriglyceridemiainduced pancreatitis are also discussed.
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.
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.
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 important metabolic disease and strongly associated with the development of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is affected by various factors and might occur owing to the complex synergistic interaction between the genetic background and environmental 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.
