Hypertriglyceridemia refers to high blood levels of triglycerides. It has been associated with atherosclerosis and can lead to pancreatitis at very high levels over 1000 mg/dl. Causes include enzyme deficiencies like lipoprotein lipase deficiency or lysosomal acid lipase deficiency that impair triglyceride breakdown. Other causes are high carbohydrate diets, obesity, diabetes, excess alcohol, genetic factors, and medical conditions like nephrotic syndrome. Treatment involves dietary changes to restrict carbohydrates and fat as well as medications like niacin, fibrates, statins, and fish oil to lower triglyceride levels.

1. Hypertriglyceridemia
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2. Hypertriglyceridemia
hypertriglyceridemia denotes high blood
levels triglycerides.
It has been associated with atherosclerosis,
even in the absence of
hypercholesterolemia.
It can also lead to pancreatitis in excessive
concentrations (i.e. when the triglyceride
concentration is greater, and often very
much greater, than 1000 mg/dl or

3. Signs and symptoms
Modestly elevated triglyceride levels do not
lead to any physical symptoms.
 Higher levels are associated with lipemia
retinalis (white appearance of the retina),
Eruptive xanthomas (small lumps in the
skin, sometimes itchy)

4. Causes:
A.Enzyme dependent
B.Non enzyme dependent ( other causes )
A. Enzyme dependent :
1. Lipoprotein lipase deficiency
2. Lysosomal acid lipase deficiency

5. Lipoprotein lipase deficiency
(known as chylomicronemia)
chylomicronemia and hyperlipoproteinemia type
Ia is caused by a mutation in the gene which
codes lipoprotein lipase.
Lipoprotein lipase (Lps):
is a member of the lipase gene family, which
includes pancreatic lipase, hepatic lipase, and
endothelial lipase.
It is a water soluble enzyme that hydrolyzes
triglycerides in lipoproteins, such as those
found in chylomicrons and very low-density
lipoproteins (VLDL), into two free fatty acids
and one monoacylglycerol molecule.

6. 2.Lysosomal Acid Lipase Deficiency :
happens when the body does not produce
enough active LAL enzyme.
This enzyme plays an important role in breaking
down fatty material (cholesteryl esters and
triglycerides) in the body.
The lack of the LAL enzyme can lead to a
build-up of fatty material in a number of body
organs including the liver, spleen, gut, in the
wall of blood vessels and other important
organs.

7. Abnormalities that a person may have
in(Cholesteryl Ester Storage Disease) include:
A high cholesterol and high triglyceride level
A high 'bad' cholesterol ( LDL)
A very low 'good' cholesterol (HDL)
Unexplained hepatomegaly (liver enlargement)
Elevated liver enzymes (a marker of liver
damage)
Unexplained fat or lipid material in the liver
Unexplained chronic liver disease that may be
getting worse over time

9. B. Other causes :
High carbohydrate diet
Idiopathic
Obesity
Diabetes mellitus and insulin resistance - it is
one of the defined components of metabolic
syndrome
Excess alcohol intake

10. renal failure, Nephrotic syndrome
Genetic predisposition; some forms of familial
hyperlipidemia such as familial combined
hyperlipidemia
Systemic Lupus Erythematosus Glycogen
storage disease type 1.

11. Treatment
Treatment of hypertriglyceridemia is by
restriction of carbohydrates and fat in the diet
.
As well as with niacin, fibrates and statins
(three classes of drugs).
Increased fish oil intake may substantially
lower an individual's triglycerides

12. Note:
Niacin (also known as vitamin B3, nicotinic
acid and vitamin PP) blocks the breakdown
of fats, it causes a decrease in free fatty acids
in the blood and, as a consequence,
decreases the secretion of VLDL and
cholesterol by the liver.
Fibrates are a class of amphipathic carboxylic
acids used in accessory therapy in many
forms of hypercholesterolemia, usually in
combination with statins

13. Statins (or HMG-CoA reductase inhibitors)
are a class of drugs used to lower cholesterol
levels by inhibiting the enzyme HMG-CoA
reductase, which plays a central role in the
production of cholesterol in the liver.
prevention
Omega-3 fatty acid supplementation in the
form of fish oil has been found to be effective
in decreasing levels of triglycerides and all
cardiovascular events by 19% to 45%