TAILIEUCHUNG - Hypertriglyceridemia

A healthy 45-year-old man is found on routine screening to have hypertriglyceridemia. He is a nonsmoker, has a reasonable diet, consumes one alcoholic drink per week, and exercises regularly. He takes no medications. His father died at the age of 55 years in an automobile accident; his mother is healthy at 67 years of age, and he has two healthy older brothers. His blood pressure is normal, his body-mass index (the weight in kilograms divided by the square of the height in meters) is 28, and his waist circumference is 96 cm. His fasting triglyceride level is 400 mg per deciliter, total cholesterol 230 mg deciliter, low-density. | Hypertriglyceridemia Hypertriglyceridemia John D. Brunzell . This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented followed by a review offormalguidelines when they exist. The article ends with the author s clinical recommendations. A healthy 45-year-old man is found on routine screening to have hypertriglyceridemia. He is a nonsmoker has a reasonable diet consumes one alcoholic drink per week and exercises regularly. He takes no medications. His father died at the age of 55 years in an automobile accident his mother is healthy at 67 years of age and he has two healthy older brothers. His blood pressure is normal his body-mass index the weight in kilograms divided by the square of the height in meters is 28 and his waist circumference is 96 cm. His fasting triglyceride level is 400 mg per deciliter total cholesterol 230 mg deciliter low-density lipoprotein LDL cholesterol 120 mg per deciliter and high-density lipoprotein HDL cholesterol 30 mg per deciliter. His fasting blood glucose level is 90 mg per deciliter. Thyroid and renal function are normal. How should his case be assessed and managed the clinical problem Hypertriglyceridemia is a common form of dyslipidemia1 that is frequently associated with premature coronary artery disease 2-5 which is generally defined by the occurrence of a myocardial infarction or the need for a coronary-artery procedure before 55 years of age for men and 65 years of age for women. These upper age limits might increase by 5 to 10 years in nonsmoking men and women. Whether hypertriglyceridemia causes coronary artery disease or is a marker for other lipoprotein abnormalities that cause premature coronary artery disease remains Specifically hypertriglyceridemia correlates strongly with the presence of small dense particles of LDL cholesterol and reductions in the HDL2 component of HDL cholesterol both of which are known to be

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