[Hypertriglyceridemia--diagnostics, risk and treatment].

BACKGROUND

Hypertriglyceridemia and low HDL cholesterol values are associated with adiposity, type 2 diabetes and metabolic syndrome.

METHODS

This review article is based on literature studies, data from Rikshospitalet and Furst Medical Laboratory, sales figures for fibrates and clinical experience.

RESULTS AND INTERPRETATION

Insulin resistance is a common contributory cause to hypertriglyceridaemia. In hypertriglyceridaemia, fasting glucose, HbA1c, TSH, creatinine, ALAT, ASAT, gamma GT, ALP and urine strips should be measured. The patient must be evaluated with regard to adiposity, use of alcohol, eating disorders and pregnancy. Direct measurement of LDL cholesterol gives a correct measure independent of the triglyceride level up to 13.0 mmol/L. LDL cholesterol levels may be low despite high total cholesterol levels and high triglyceride levels. Diet and lifestyle intervention is important. Blood sugar control is crucial. Statins are the first choice of drugs in combined hyperlipidaemia. Isolated hypertriglyceridaemia >10 mmol/L represents a large risk for pancreatitis. Purified omega-3 fatty acids, fibrates and eventually niacin are the drugs of choice in this condition. If LDL cholesterol levels are elevated, statins should also be considered. Combination of statin/fibrate or statin/niacin increase the risk of myopathy.