高トリグリセリド血症
- 関
- hypertriglyceridaemic、hypertriglyceridemia、hypertriglyceridemic
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/04/26 00:02:22」(JST)
[Wiki en表示]
| Hypertriglyceridemia |
| Classification and external resources |
| ICD-10 |
E78.1, E78.2, E78.3 |
| ICD-9 |
272.1 |
| OMIM |
145750 |
| DiseasesDB |
6372 |
| MedlinePlus |
000397 |
| eMedicine |
med/2921 |
| MeSH |
D015228 |
Hypertriglyceridemia denotes high (hyper-) blood levels (-emia) of triglycerides, the most abundant fatty molecule in most organisms. Elevated levels of triglycerides are associated with atherosclerosis, even in the absence of hypercholesterolemia (high cholesterol levels), and predispose to cardiovascular disease. Very high triglyceride levels also increase the risk of acute pancreatitis. Hypertriglyceridemia itself is usually symptomless, although high levels may be associated with skin lesions known as xanthomas.[1]
The diagnosis is made on blood tests, often performed as part of screening. Once diagnosed, other blood tests are usually required to determine whether the raised triglyceride level is caused by other underlying disorders ("secondary hypertriglyceridemia") or whether no such underlying cause exists ("primary hypertriglyceridaemia"). There is a hereditary predisposition to both primary and secondary hypertriglyceridemia.[1]
Weight loss and dietary modification may be effective in hypertriglyceridemia. The decision to treat hypertriglyceridemia with medication depends on the levels and on the presence of other risk factors for cardiovascular disease. Very high levels that would increase the risk of pancreatitis is treated with a drug from the fibrate class. Niacin and omega-3 fatty acids as well as drugs from the statin class may be used in conjunction, with statins being the main drug treatment for moderate hypertriglyceridemia where reduction of cardiovascular risk is required.[1]
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Contents
- 1 Signs and symptoms
- 2 Causes
- 3 Treatment
- 4 References
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Signs and symptoms
Most people with elevated triglycerides experience no symptoms. Some forms of primary hypertriglyceridemia can lead to specific symptoms: both familial chylomicronemia and primary mixed hyperlipidemia include skin symptoms (eruptive xanthoma), eye abnormalities (lipemia retinalis), hepatosplenomegaly (enlargement of the liver and spleen), and neurological symptoms. Some experience attacks of abdominal pain that may be mild episodes of pancreatitis. Eruptive xanthomas are 2-5 mm papules, often with a red ring around them, that occur in clusters on the skin of the trunk, buttocks and extremities.[2] Familial dysbetalipoproteinemia causes larger, tuberous xanthomas; these are red or orange and occur on the elbows and knees. Palmar crease xanthomas may also occur.[2][1]
Acute pancreatitis occurs in people whose triglyceride levels are above 1000 mg/dl (11.3 mmol/l).[1][2][3] Hypertriglyceridemia is associated with 1–4% of all cases of pancreatitis. The symptoms are similar to pancreatitis secondary to other causes, although the presence of xanthomas or risk factors for hypertriglyceridemia may offer clues.[3]
Causes
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This section does not cite any references or sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (September 2012) |
- High carbohydrate diet
- Idiopathic (constitutional)
- Obesity
- Diabetes mellitus and insulin resistance - it is one of the defined components of metabolic syndrome (along with central obesity, hypertension, and hyperglycemia)
- Excess alcohol intake
- renal failure, Nephrotic syndrome
- Genetic predisposition; some forms of familial hyperlipidemia such as familial combined hyperlipidemia i.e. Type II hyperlipidemia
- Lipoprotein lipase deficiency - Deficiency of this water soluble enzyme, that hydrolyzes triglycerides in lipoproteins, leads to elevated levels of triglycerides in the blood.
- Lysosomal acid lipase deficiency or Cholesteryl ester storage disease
- Certain medications e.g. isotretinoin, estrogen, hydrochlorothiazide diuretics, beta blockers, protease inhibitors
- Hypothyroidism (underactive thyroid)
- Systemic Lupus Erythematosus
- Glycogen storage disease type 1.
Treatment
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This section requires expansion. (September 2012) |
For people with mildly or moderately high levels of triglycerides lifestyle changes are recommended.[1] This may include restriction of carbohydrates and fat in the diet. Medications are recommended in those with high levels of triglycerides, with fibrates being recommended first.[1]
References
- ^ a b c d e f g Berglund L, Brunzell JD, Goldberg AC, et al. (September 2012). "Evaluation and treatment of hypertriglyceridemia: an endocrine society clinical practice guideline". J. Clin. Endocrinol. Metab. 97 (9): 2969–89. doi:10.1210/jc.2011-3213. PMC 3431581. PMID 22962670.
- ^ a b c Yuan G, Al-Shali KZ, Hegele RA (April 2007). "Hypertriglyceridemia: its etiology, effects and treatment". CMAJ 176 (8): 1113–20. doi:10.1503/cmaj.060963. PMC 1839776. PMID 17420495.
- ^ a b Tsuang W, Navaneethan U, Ruiz L, Palascak JB, Gelrud A (April 2009). "Hypertriglyceridemic pancreatitis: presentation and management". Am. J. Gastroenterol. 104 (4): 984–91. doi:10.1038/ajg.2009.27. PMID 19293788.
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Inborn error of lipid metabolism: dyslipidemia (E78, 272.0–272.6)
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| Hyperlipidemia |
- Hypercholesterolemia/Hypertriglyceridemia
- Lipoprotein lipase deficiency/Type Ia
- Familial apoprotein CII deficiency/Type Ib
- Familial hypercholesterolemia/Type IIa
- Combined hyperlipidemia/Type IIb
- Familial dysbetalipoproteinemia/Type III
- Familial hypertriglyceridemia/Type IV
- Xanthoma/Xanthomatosis
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| Hypolipoproteinemia |
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Hypoalphalipoproteinemia/HDL
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- Lecithin cholesterol acyltransferase deficiency
- Tangier disease
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Hypobetalipoproteinemia/LDL
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- Abetalipoproteinemia
- Apolipoprotein B deficiency
- Chylomicron retention disease
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| Lipodystrophy |
- Barraquer–Simons syndrome
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| Other |
- Lipomatosis
- Adiposis dolorosa
- Lipoid proteinosis
- APOA1 familial renal amyloidosis
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mt, k, c/g/r/p/y/i, f/h/s/l/o/e, a/u, n, m
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k, cgrp/y/i, f/h/s/l/o/e, au, n, m, epon
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m (A16/C10), i (k, c/g/r/p/y/i, f/h/s/o/e, a/u, n, m)
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UpToDate Contents
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English Journal
- Dynamic microvesicle release and clearance within the cardiovascular system: triggers and mechanisms.
- Ayers L1, Nieuwland R2, Kohler M3, Kraenkel N4, Ferry B5, Leeson P6.
- Clinical science (London, England : 1979).Clin Sci (Lond).2015 Dec 1;129(11):915-31. doi: 10.1042/CS20140623.
- Interest in cell-derived microvesicles (or microparticles) within cardiovascular diagnostics and therapeutics is rapidly growing. Microvesicles are often measured in the circulation at a single time point. However, it is becoming clear that microvesicle levels both increase and decrease rapidly in r
- PMID 26359252
- Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias: A systematic review and meta-analysis.
- Nduka C1, Sarki A2, Uthman O3, Stranges S4.
- International journal of cardiology.Int J Cardiol.2015 Nov 15;199:307-18. doi: 10.1016/j.ijcard.2015.07.052. Epub 2015 Jul 23.
- BACKGROUND: Antiretroviral drugs increase biosynthesis and reduce hepatic clearance of serum cholesterol. It is thus important to evaluate the impact of antiretroviral treatment on serum lipoprotein levels and the risk of dyslipidemia.METHODS: We searched EMBASE and PubMed for articles comparing lip
- PMID 26241636
- Hypertriglyceridemia is a Major Factor Associated With Elevated Levels of Small Dense LDL Cholesterol in Patients With Metabolic Syndrome.
- Cho Y1,2, Lee SG3, Jee SH4, Kim JH5.
- Annals of laboratory medicine.Ann Lab Med.2015 Nov;35(6):586-94. doi: 10.3343/alm.2015.35.6.586.
- BACKGROUND: We aimed to determine the major contributing component of metabolic syndrome (MetS) that results in an elevated small dense LDL cholesterol (sdLDL-C) concentration and sdLDL-C/LDL-C ratio.METHODS: Four hundred and forty-seven subjects (225 men; 222 women) with MetS were randomly selected
- PMID 26354346
Japanese Journal
- Membrane Localization of Protein-Tyrosine Phosphatase 1B is Essential for its Activation of Sterol Regulatory Element-Binding Protein-1 Gene Expression and Consequent Hypertriglyceridaemia
- UGI Satoshi,SHI Kun,NISHIO Yoshihiko,SHIMIZU Shinya,GUO Baoliang,SEKINE Osamu,IKEDA Kazuhiro,EGAWA Katsuya,YOSHIZAKI Takeshi,NAGAI Yoshio,KOYA Daisuke,TAKADA Tatsuyuki,TORII Ryozo,KIMURA Hiroshi,KASHIWAGI Atsunori,MAEGAWA Hiroshi
- The journal of biochemistry 146(4), 541-547, 2009-10-01
- NAID 10026304029
- 今月の症例 脂質代謝異常を伴い全身に多発した若年性黄色肉芽腫の1例
Related Links
- ... caused by other underlying disorders ("secondary hypertriglyceridemia") or whether no such underlying cause exists ("primary hypertriglyceridaemia"). There is a hereditary predisposition to both primary and secondary hypertriglyceridemia .
- Hypertriglyceridaemia is most commonly due to a secondary cause. secondary causes of raised TG include: high alcohol intake, renal disease, drugs (retinoids, cyclosporin, some beta blockers, oestrogens, corticosteroids, protease inhibitors), ...
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- hypertriglyceridaemia、hypertriglyceridaemic、hypertriglyceridemia
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高トリグリセリド血症の
- 関
- hypertriglyceridaemia、hypertriglyceridemia、hypertriglyceridemic