Hypertriglyceridemia—Causes, Significance, and Approaches to Therapy

Santos-Baez, Leinys S; Ginsberg, Henry N.

doi:10.3389/fendo.2020.00616

Cited by 39 publications

(30 citation statements)

References 63 publications

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“…Both ANGPTL3 and ANGPTL8 interact as regulators of LPL activity, and both are targets for pharmacotherapeutic agents currently undergoing testing as potentially effective drugs in the treatment of hypertriglyceridemia. The most common lipid disorder in the general Caucasian population affecting >60% is hypercholesterolemia; however, the prevalence of hypertriglyceridemia is also quite high, amounting to some 27-30% and higher in men than in women [1,17,18]. In this study, the proportion of hypertriglyceridemia in females and males was representative of a Polish population.…”

Section: Discussionmentioning

confidence: 80%

Relationship between Serum Angiopoietin-like Proteins 3 and 8 and Atherogenic Lipid Biomarkers in Non-Diabetic Adults Depends on Gender and Obesity

et al. 2021

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Hypertriglyceridemia is an independent risk factor for coronary artery disease. Lipoprotein lipase (LPL) plays an essential role in the metabolism of triglyceride-rich lipoproteins (TRLs). Angiopoietin-like proteins ANGPTL3 and ANGPTL8 are shown to be important regulators of LPL activity. Increased concentrations of these proteins may reflect cardiovascular risk, and the treatment of patients with dyslipidemia with ANGPTLs inhibitors may decrease this risk. We assessed the gender-specific relationships of serum ANGPTL3 and ANGPTL8 with atherogenic lipid biomarkers and obesity in non-diabetic adults. The study comprised 238 participants aged 25–74 [122 with triglycerides (TG) <150 mg/dL (<1.7 mmol/L) and 116 with hypertriglyceridemia]. Total cholesterol, HDL-cholesterol, LDL-cholesterol, TG, C-reactive protein (CRP), glycated hemoglobin, apolipoprotein B, small dense LDL-C (sd-LDL-C), ANGPTL3, and ANGPTL8 were measured. Non-HDL-cholesterol, remnant cholesterol (remnant-C) concentrations, and body mass index (BMI) were calculated. Results: Women and men did not differ in terms of age, CRP levels, the percentage of obese subjects, and concentrations of atherogenic lipid biomarkers, except higher TG in males and higher ANGPTL3 concentrations in females. Positive correlations of both ANGPTLs with TG, remnant-C, and sdLDL-C levels were found in females. In males, only ANGPTL3 correlated positively with atherogenic biomarkers, but there were no correlations with ANGPTL8. Concentrations of ANGPTL3 were higher in obese men, whereas ANGPTL8 levels were higher in obese women. In women alone, ANGPTL8 showed very good discrimination power to identify subjects with hypertriglyceridemia (AUC = 0.83). Contrary to this, ANGPTL3 was a better discriminator of hypertriglyceridemia (AUC = 0.78) in male subjects. Regression models, adjusted for age, sex, and BMI showed a weak but significant effect of ANGPTL8 to increase the risk of hypertriglyceridemia. Conclusions: In females, ANGPTL8 is more strongly associated with TRLs metabolism, whereas in males, ANGPTL3 plays a more important role. We suggest sex differences be taken into consideration when applying new therapies with angiopoietin-like proteins inhibitors in the treatment of dyslipidemia.

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Section: Discussionmentioning

confidence: 80%

Relationship between Serum Angiopoietin-like Proteins 3 and 8 and Atherogenic Lipid Biomarkers in Non-Diabetic Adults Depends on Gender and Obesity

et al. 2021

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“…Secondary causes of HTG comprise lifestyle factors (alcohol, high saturated fat, high refined sugar and hypercaloric diets consumption and smoking), medical conditions (obesity, metabolic syndrome (MS), hypothyroidism, diabetes mellitus, renal disorders, Cushing’s syndrome, pregnancy, HIV-associated lipodystrophy), acromegaly, and drugs (thiazides, beta blockers, steroid hormones and others) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Cardiovascular diseases (CVD) have been associated with HTG but in a controversial manner; nevertheless, TG-rich lipoproteins such as chylomicrons and VLDL are linked to CVD [ 14 ]. HTG is an important marker of increased levels of highly atherogenic remnant-like particles, non-alcoholic fatty liver, and pancreatitis risk.…”

Section: Introductionmentioning

confidence: 99%

“…HTG is an important marker of increased levels of highly atherogenic remnant-like particles, non-alcoholic fatty liver, and pancreatitis risk. General treatment of HTG uses fibrates, statins, and omega-3 fatty acids combined with lifestyle changes [ 13 , 14 ]. Moreover, intravenous insulin infusion is used to reduce serum TG through the activation of LPL but mainly in patients with acute pancreatitis, which is an ailment often caused by HTG [ 7 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Dietary Interventions on Hypertriglyceridemia: From Public Health to Molecular Nutrition Evidence

et al. 2022

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Approximately 25–50% of the population worldwide exhibits serum triglycerides (TG) (≥150 mg/dL) which are associated with an increased level of highly atherogenic remnant-like particles, non-alcoholic fatty liver disease, and pancreatitis risk. High serum TG levels could be related to cardiovascular disease, which is the most prevalent cause of mortality in Western countries. The etiology of hypertriglyceridemia (HTG) is multifactorial and can be classified as primary and secondary causes. Among the primary causes are genetic disorders. On the other hand, secondary causes of HTG comprise lifestyle factors, medical conditions, and drugs. Among lifestyle changes, adequate diets and nutrition are the initial steps to treat and prevent serum lipid alterations. Dietary intervention for HTG is recommended in order to modify the amount of macronutrients. Macronutrient distribution changes such as fat or protein, low-carbohydrate diets, and caloric restriction seem to be effective strategies in reducing TG levels. Particularly, the Mediterranean diet is the dietary pattern with the most consistent evidence for efficacy in HTG while the use of omega-3 supplements consumption is the dietary component with the highest number of randomized clinical trials (RCT) carried out with effective results on reducing TG. The aim of this review was to provide a better comprehension between human nutrition and lipid metabolism.

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“…In patients with elevated triglycerides, cLDL estimation may be wrong. In this scenario, it is useful to know that in cases where triglyceride levels are > 400mg/dL, serum levels of cLDL must be directly determined, instead of using the Friedewald formula [cLDL = total cholesterol – (cHDL + triglycerides/5)], which could lead to cLDL inaccuracies when triglycerides are elevated beyond those previously mentioned ( 54 ).…”

Section: Frequent Mistakes In the Evaluation Of Miscellaneous Endocrine Testsmentioning

confidence: 99%

Common Pitfalls in the Interpretation of Endocrine Tests

et al. 2021

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Endocrine tests are the cornerstone of diagnosing multiple diseases that primary care physicians are frequently faced with. Some of these tests can be affected by situations that affect the proper interpretation, leading to incorrect diagnoses and unnecessary treatment, such as the interference of biotin with thyroid function test, falsely elevated prolactin values in presence of macroprolactinemia or falsely normal due to the “hook effect” in macroprolactinomas. Recognizing these situations is essential for the clinician to make an adequate interpretation of these tests as well as an accurate diagnosis that guarantees the best outcomes for the patient.

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Hypertriglyceridemia—Causes, Significance, and Approaches to Therapy

Cited by 39 publications

References 63 publications

Relationship between Serum Angiopoietin-like Proteins 3 and 8 and Atherogenic Lipid Biomarkers in Non-Diabetic Adults Depends on Gender and Obesity

Relationship between Serum Angiopoietin-like Proteins 3 and 8 and Atherogenic Lipid Biomarkers in Non-Diabetic Adults Depends on Gender and Obesity

The Effect of Dietary Interventions on Hypertriglyceridemia: From Public Health to Molecular Nutrition Evidence

Common Pitfalls in the Interpretation of Endocrine Tests

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