Hypertriglyceridaemia

Last reviewed: 6 Sep 2022
Last updated: 21 Sep 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • eruptive xanthomas
  • lipaemia retinalis
More key diagnostic factors

Other diagnostic factors

  • obesity/overweight
  • diabetes
  • coronary artery disease/angina
  • claudication
  • neurological features
  • aortic valve disease
  • abdominal pain and features of pancreatitis
Other diagnostic factors

Risk factors

  • family history of hyperlipidaemia
  • high saturated fat diet
  • high carbohydrate or high glycaemic index diet
  • excessive alcohol consumption
  • family or personal history of overweight/obesity
  • family or personal history of diabetes
  • insulin resistance
  • liver disease
  • renal disease
  • HIV infection
  • medications
  • Cushing syndrome
  • inflammatory/immune disorders
  • organ transplant
  • hypothyroidism
  • pregnancy
More risk factors

Diagnostic investigations

1st investigations to order

  • triglyceride level
More 1st investigations to order

Investigations to consider

  • apolipoprotein B
  • fasting plasma glucose
  • urea, creatinine
  • urinary albumin/protein
  • serum albumin
  • thyroid-stimulating hormone
  • liver function tests
  • C-reactive protein
More investigations to consider

Treatment algorithm

ACUTE

chylomicronaemia

ONGOING

moderate HTG (fasting TG ≥1.7 mmol/L [≥150 mg/dL] or non-fasting TG ≥2.0 mmol/L [≥175 mg/dL] and TG <5.6 mmol/L [<500 mg/dL])

severe HTG (fasting TG ≥5.6 mmol/L [≥500 mg/dL] especially fasting TG ≥11.3 mmol/L [≥1000 mg/dL])

Contributors

Authors

Robert A. Hegele, MD, FRCPC, FACP, FAHA

Jacob J. Wolfe Distinguished Medical Research Chair

Martha Blackburn Chair in Cardiovascular Research

Distinguished University Professor of Medicine and Biochemistry

University of Western Ontario

London

Ontario

Canada

Disclosures

RAH reports consulting fees from Acasti, Aegerion, Akcea/Ionis, Amgen, HLS Therapeutics, Novartis, Pfizer, Regeneron, and Sanofi. RAH is an author of references cited in this topic.

Acknowledgements

Dr Robert A. Hegele would like to gratefully acknowledge Dr David Alexander Leaf, the previous contributor to this topic.

Disclosures

DAL declares that he has no competing interests.

Peer reviewers

Mahi Lakshmi Ashwath, MD

Assistant Professor of Medicine

Division of Cardiology

Heart and Vascular Center

Metro Health Medical Center

Case Western Reserve University

Cleveland

OH

Disclosures

MLA declares that he has no competing interests.

  • Hypertriglyceridaemia images
  • Differentials

    • Diabetes
    • Lipodystrophies
    • Liver disease
    More Differentials
  • Guidelines

    • 2021 ACC expert consensus decision pathway on the management of ASCVD risk reduction in patients with persistent hypertriglyceridemia
    • 2021 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in adults
    More Guidelines
  • Patient leaflets

    High cholesterol

    More Patient leaflets
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