Triglyceride disorders

Hypertriglyceridaemia (particularly with levels > 10 mmol/L) is a risk factor for acute pancreatitis.

The association between hypertriglyceridaemia and risk of coronary heart disease is complex and not necessarily dependent on triglyceride level. There is a strong inverse relationship between triglyceride level and HDL level. Low HDL levels are associated with an increased risk of coronary heart disease. However note that triglycerides still confer a degree of independent risk even after accounting for HDL cholesterols.

Note that hypertriglyceridaemia is often classified as moderate (2.3mmol-10mmol/L) and severe (>10mmol/L). This classification is rather arbitrary and under certain circumstances an individual with normal moderate-fasting hypertriglyceridaemia may develop severe hypertriglyceridaemia.

In severe hypertriglyceridaemia, even in fasting samples, chylomicrons will be a major contributor to the hyperlipidaemia (both chylomicrons and VLDL) compete for clearance via lipoprotein lipase. In severe hypertriglyceridaemia there will generally be a type V (VLDL and chylomicrons) phenotype rather than type I (chylomicrons). Often severe hypertriglyceridaemia occurs when there is an increased VLDL production from the liver (familial or secondary (e.g. diabetes, alcohol, alcohol, oestrogen administration)) in conjunction with reduced triglyceride clearance (e.g. familial or secondary (hypothyroidism, beta-blocker treatment, diabetes)).

Some familial and secondary causes of hypertriglyceridaemia are described in this section of GPnotebook.