ApoE isoform leading to hypertriglyceridemia in new onset type 1 diabetes

Keefe, C.; Lawson, Sarah

doi:10.1002/ccr3.1584

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…18 Mutation in LPL gene can lead to severe and persistent hypertriglyceridemia in DKA that does not improve with insulin alone. 30 On the other hand, a severe but not persistent hypertriglyceridemia may be caused by abnormality in lipoprotein cofactors. 30 It is possible that subtle abnormality in lipid metabolism in usual conditions may contribute to the development of hyperlipidemia under stress such as DM.…”

Section: Discussionmentioning

confidence: 99%

“…30 On the other hand, a severe but not persistent hypertriglyceridemia may be caused by abnormality in lipoprotein cofactors. 30 It is possible that subtle abnormality in lipid metabolism in usual conditions may contribute to the development of hyperlipidemia under stress such as DM. Karagianni et al have reported a case with similar severe hyperlipidemia in DKA.…”

Section: Discussionmentioning

confidence: 99%

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Very Severe Hypertriglyceridemia in Children with Diabetic Ketoacidosis

Sari¹,

Rini²,

Khairunnisa³

2021

JKS

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Background: Hypertriglyceridemia can be observed in up to 50% of patients with diabetic ketoacidosis (DKA), but a condition for DKA with very severe hypertriglyceridemia is uncommon. The objective of this case report is to present and describe the clinical features, laboratory investigations, case management, and natural course of hypertriglyceridemia in DKACase summary: A 9-year-old girl referred by district hospital with DKA and hypertriglyceridemia. Chief complaint was a decreased in consciousness for 16 hours before the admission. Patient has been known to suffer from diabetes mellitus within these 9 months. At ER patient looked severely ill, GCS 7, Kussmaul breathing. Random blood glucose was 255 mg/dL. Glycosuria and ketone urine tests were positive. Triglyceride level was 16.200 mg/dL. She had diagnosed with diabetic encephalopathy, DKA and very severe hypertriglyceridemia due to DKA. We treat DKA with standard guidelines, and on the 15th day we gave additional therapy fibrates and omega oil to treat the very severe hypertriglyceridemia. The level of triglyceride decreased gradually with hydration and insulin in standard guideline for DKA but didn’t achieve the normal level. With additional treatment, normal level of triglyceride achieved without any clinical side effects.Conclusion: Triglyceride level should be monitored in DKA patients. The hypertriglyceridemia can be treated by hydration, insulin, fibrates, and omega oil. The use of these treatment need to be evaluated for side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Very Severe Hypertriglyceridemia in Children with Diabetic Ketoacidosis

Sari¹,

Rini²,

Khairunnisa³

2021

JKS

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“…Therefore, in insulin deficiency, LPL cannot metabolize lipoproteins and hypertriglyceridemia can occur. It has been suggested that patients with lipemic serum and significant elevations in triglycerides (> 1,495 mg/dL, > 16.9 mmol/L) be considered for further screening for lipid metabolism and structural abnormalities [ 7 ]. Our patient’s family history was negative for dyslipidemia conditions, and genetic testing for disorders of lipid metabolism is being considered.…”

Section: Discussionmentioning

confidence: 99%

Severe Hypertriglyceridemia With New-Onset Type 1 Diabetes in Diabetic Ketoacidosis

et al. 2020

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Hypertriglyceridemia is a complication in the presentation of diabetic ketoacidosis (DKA) but has been reported in the pediatric population infrequently. We report a 13-year-old female with new onset type 1 diabetes in DKA, who developed extreme hypertriglyceridemia. Our patient's case is unique as her triglyceride levels were markedly higher than those in other reports and required a longer duration of time to resolve. We review the literature on the concomitant presentation of DKA and hypertriglyceridemia, as well as its pathophysiology and treatment.

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“…This results in free fatty acid (FFA) formation and increases in VLDL formation by the liver. 9 In addition to this, insulin normally inhibits ApoC-III expression, which plays a major role in inhibiting lipoprotein lipase (LPL) and hepatic lipase (HL). Insulin deficiency results in decreased hydrolysis and delayed VLDL-TG clearances from plasma.…”

Section: Case Reportmentioning

confidence: 99%

“…It has been suggested by many authors that patients presented with lipemic serum and severe elevations in triglycerides (>1,495 mg/dl, >16.9 mmol/l) should be considered for further screening for lipid metabolism and structural abnormalities. 9 Mild to moderate hypertriglyceridemia is common during episodes of DKA. However, severe hypertriglyceridemia which is defined as a TG level >2,000 mg/dl, is rare.…”

Section: Case Reportmentioning

confidence: 99%

Severe diabetic ketoacidosis complicated with severe dyslipidemia, cerebral edema and acute kidney injury in a pediatric girl with type 1 diabetes mellitus: a case study

Daxay,

Yadav,

Anigani

et al. 2023

Int J Contemp Pediatr

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Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication occurring in patients with type 1 diabetes, due to an insulin deficiency. Moderate hypertriglyceridemia is commonly observed in DKA but severe hypertriglyceridemia with a triglyceride level exceeding 10 g/l is very rarely reported. Acute kidney injury (AKI) is a serious condition which still carries a mortality of around 50%. Cerebral edema is a devastating complication of DKA which is leading cause of diabetes-related death in the pediatric population. Newly diagnosed diabetes, younger age, first episode of DKA, severity of DKA at presentation, and administration of bicarbonate are predictive of cerebral edema in DKA. We present a case of 8-year-old girl who presented with severe DKA, whose clinical course was complicated by renal failure, severe dyslipidemia and cerebral edema.

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ApoE isoform leading to hypertriglyceridemia in new onset type 1 diabetes

Cited by 3 publications

References 21 publications

Very Severe Hypertriglyceridemia in Children with Diabetic Ketoacidosis

Very Severe Hypertriglyceridemia in Children with Diabetic Ketoacidosis

Severe Hypertriglyceridemia With New-Onset Type 1 Diabetes in Diabetic Ketoacidosis

Severe diabetic ketoacidosis complicated with severe dyslipidemia, cerebral edema and acute kidney injury in a pediatric girl with type 1 diabetes mellitus: a case study

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