Last reviewed: 4 Sep 2023
Last updated: 06 Jun 2023
Summary
Definition
History and exam
Key diagnostic factors
- eruptive xanthomas
- lipemia retinalis
More key diagnostic factors
Other diagnostic factors
- obesity/overweight
- diabetes
- lipodystrophy
- coronary artery disease/angina
- claudication
- aortic valve disease
- neurologic features
- abdominal pain and features of pancreatitis
Other diagnostic factors
Risk factors
- family history of hyperlipidemia
- high saturated fat diet
- high carbohydrate or high glycemic 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
- BUN, creatinine
- urinary albumin/protein
- serum albumin
- thyroid-stimulating hormone
- liver function tests
- C-reactive protein
More investigations to consider
Treatment algorithm
ACUTE
chylomicronemia
ONGOING
moderate HTG (fasting TG ≥150 mg/dL [≥1.7 mmol/L] or nonfasting TG ≥175 mg/dL [≥2.0 mmol/L] and TG <500 mg/dL [<5.6 mmol/L])
severe HTG (fasting TG ≥500 mg/dL [≥5.6 mmol/L] especially fasting TG ≥1000 mg/dL [≥11.3 mmol/L])
Contributors
Authors
Robert A. Hegele, MD, FRCPC, Cert Endo, 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, Boston Heart, HLS Therapeutics, Novartis, Pfizer, Regeneron, Sanofi and UltraGenyx. 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
Vinaya Simha, MBBS, MD
Associate Professor
Mayo Clinic
Rochester
MN
Disclosures
VS declares that he has no competing interests.
Differentials
- Diabetes
- Lipodystrophies
- Liver disease
More DifferentialsGuidelines
- Cardiovascular disease: risk assessment and reduction, including lipid modification
- 2022 ACC expert consensus decision pathway on the role of nonstatin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk
More GuidelinesPatient leaflets
High cholesterol
More Patient leaflets
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