Hypertriglyceridemia is a condition where in there is an alarmingly high concentration of triglyceride in the blood. Triglycerides or triacylglcerol is a lipid formed by esterfication of three fatty acids to a glycerol molecule it is a type of fat found in the blood. When it comes to dietary discussions the term fat usually is used to substitute for triacylglycerol. The normal triglyceride level in the blood is <150mg/dl, people with Hypertiglyceridemia has a triglyceride level > 150mg/dl. Mild hypertriglyceridemia - 150-199mg/dl, Moderate hypertriglyceridemia - 200-999mg/dl, Severe hypertriglyceridemia - 1000-1999 mg/dl, and very severe hypertriglyceridemia - > 2000mg/dl. There are two main sources of plasma triglycerides. Exogenous sources (from dietary fat) carried in chylomicrons, and endogenous (from the liver) carried in very low density lipoprotein.
Hypertriglyceridemia is a risk factor for cardiovascular disease and for pancreatitis. More importantly Hypertriglyceridemia is usually accompanied with other lipid abnormalities and metabolic syndrome which is connected to coronary artery disease.
Primary Causes of Hypertriglyceridemia
Familial hypertriglyceridemia is a condition defined by an isolated very low density lipoprotein, which is not as rich in triglyceride as chylomicrons are. This type of disorder has 5-10% population prevalence. Although the molecular basis for this disorder is still unknown it is likely to be polygenic which means it requires a secondary factor for expression.
Combined Hyperlipoproteinemia has a population prevalence of 2-5%. The abnormalities associated with this disease are the increase in very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) with depressed HDL linked with an abnormal lipoprotein. People diagnosed with this disease occasionally have obligate heterozygosity for LPL or APOC3 gene mutations. The USF1 gene is recently defined to have the possibility to cause this disorder although several genes have also been claimed as causative.
Familial Dysbetalipoproteinemia has a population prevalence of 1 – 2 in 20,000. The abnormality in this disorder is an increase in triglyceride-rich lipoprotein remnants which is also known as intermediate-density lipoproteins ( Beta-VLDL). Beta VLDL produces an equimolar elevation of plasma total cholesterol and triglyceride measurements. People diagnosed with this disease are homozygotic for the binding – defective APOE E2 isoform.
Secondary Causes of Hypertriglyceridemia
Obesity and diabetes. People with overflow of visceral adipose tissue usually have high triglyceride and low levels of HDL-C. About 80% of obese men have hyperinsulinemia, high levels of apo B and small, dense LDL particles. These three things can increase the risk of having cardiovascular disease by up to 20 times. Moreover, people resistant to insulin without type 2 diabetes is associated with a number of...