Scheen A J
Université de Liège, Département de Médecine.
Rev Med Liege. 1998 Feb;53(2):103-5.
The strategy for the diagnosis of hypertriglyceridaemia comprises three successive steps. First, the physician should confirm the biological abnormality by at least one additional blood sample taken after an overnight fast; recent data, however, suggest that postprandial hypertriglyceridaemia may also represent a cardiovascular risk factor. Second, the phenotype of hypertriglyceridaemia should be considered as either isolated high triglyceride levels or hypertriglyceridaemia combined with hypercholesterolemia may be present; the combination of hypertriglyceridaemia with a low HDL cholesterol concentration or its association with the metabolic or insulin resistance syndrome should also be investigated. Third, all should be done in order to find the etiology of the hypertriglyceridaemia (by determining its genetic or nutritional origin, by excluding possible underlying pathologies, by looking for drugs able to increase serum triglyceride levels). These various steps should help the physician to take the final decision of treating one particular patient as well as to chose the most appropriate, nutritional or pharmacological, treatment.
高甘油三酯血症的诊断策略包括三个连续步骤。首先,医生应通过至少一份空腹过夜后采集的额外血样来确认生物学异常;然而,近期数据表明餐后高甘油三酯血症也可能是一种心血管危险因素。其次,高甘油三酯血症的表型应被视为要么是单纯的高甘油三酯水平,要么可能存在高甘油三酯血症合并高胆固醇血症;还应研究高甘油三酯血症与低高密度脂蛋白胆固醇浓度的组合情况,或其与代谢或胰岛素抵抗综合征的关联。第三,应采取一切措施来找出高甘油三酯血症的病因(通过确定其遗传或营养来源,排除可能的潜在病症,寻找能够升高血清甘油三酯水平的药物)。这些不同步骤应有助于医生对治疗特定患者做出最终决策,并选择最合适的营养或药物治疗方法。