" D'Oh! I have Triglycerides of 500 "
High Yield Review: Hypertriglyceridemia
Case: A 40 y/o male from Springfield Illinois with no known medical history. He comes to the clinic for follow up on his cholesterol check. On exam he is obese with central obesity, he
admits to drinking a 6 pack of Duff Beer daily, and consuming many " hmmm donuts ", and he does not exercise at all.
You report to him he has a triglyceride level of 500 mg/dl
for which his response is slapping his hand on his forehead
and saying " D'Oh! " You tell him he is at high risk for pancreatitis
and tell him to stop alcohol use, and you prescribe him fish oil
and gemfibrozil.
Case Clues- Hypertriglycerdemia
- Obese
- Central Obesity
- No Exercise / Lack of Activity
- Alcohol Use
- Triglycerides > 500
Notable Notes- Hypertriglyceridemia
Evaluate the Patient for Secondary Causes ( Acquired )
- Obesity
- High Fat Diet
- Diabetes Mellitus
- Hypothyroidism
- Alcohol
- Medications ( Estrogen, Steroids, HCTZ )
Treatment:
Hypertriglyceridemia: 150-499 mg/dl
- Diet and Lifestyle Modifications ( Weight loss, Exercise, Decrease ETOH consumption)
- GOT ASCVD ? Then start a Statin
Very Severe Hypertriglyceridemia > 500 mg/dl
- High risk for pancreatitis so STOP ETOH consumption
- Start Fish Oil and Fibrates
Know it for the boards - Hyper Triglycerdiemia !
- Triglycerides > 500 mg/dl = High Risk for Pancreatitis
- Triglycerides > 500 mg/dl start treatment with Fibrates and Fish Oil
- Stop ETOH entirely
- Be on the look out for Secondary Causes ( Think Diabetes Mellitus and Hypothryoidism )
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