From the Guidelines
Hypertriglyceridemia is associated with an increased risk of acute pancreatitis, particularly when triglyceride levels exceed 1000 mg/dL, as well as a higher risk of cardiovascular disease due to the elevation of VLDL and metabolic risk factors such as diabetes and obesity. The complications of hypertriglyceridemia can be severe and include:
- Acute pancreatitis, which can be triggered by triglyceride levels and is a relatively uncommon (9%) cause of acute pancreatitis, but patients with severe hypertriglyceridemia have a relatively high incidence (14%) of acute pancreatitis 1
- Increased risk of cardiovascular disease, as elevations of VLDL and a higher prevalence of several metabolic risk factors (eg, diabetes, obesity) raise the risk of ASCVD 1
- Other potential complications, such as fatty liver disease, xanthomas, and lipemia retinalis, although these are not directly mentioned in the provided evidence, they are known complications of hypertriglyceridemia To manage triglyceride levels and prevent these complications, lifestyle interventions including Medical Nutrition Therapy (MNT) are important for all patients with elevated triglycerides, with a very rigorous approach advised for patients with triglycerides ≥1,000 mg/dL. Specifically, for patients with triglycerides 500 to 999 mg/dL, 20% to 25% of calories from fat are recommended, and for patients with triglycerides ≥1,000 mg/dL, 10% to 15% of calories from fat are recommended 1. Clinicians may opt to further reduce total fat as a percent of calories. Regular monitoring of triglyceride levels is essential for effective management.
From the FDA Drug Label
Markedly elevated levels of serum triglycerides (e.g., > 2,000 mg/dL) may increase the risk of developing pancreatitis.
The complication of hypertriglyceridemia (elevated triglycerides) is an increased risk of developing pancreatitis, especially when serum triglyceride levels exceed 2,000 mg/dL. 2
From the Research
Complications of Hypertriglyceridemia
The complications of hypertriglyceridemia include:
- Cardiovascular disease: Hypertriglyceridemia is causally linked to cardiovascular disease 3, 4, 5
- Pancreatitis: Elevated triglyceride levels above 1000 mg/dL can induce acute pancreatitis 3, 4, 6, 7
- Atherosclerotic cardiovascular disease (ASCVD): Severe hypertriglyceridemia is associated with major complications such as ASCVD 6
Risk Factors for Complications
The risk factors for complications of hypertriglyceridemia include:
- Severity of hypertriglyceridemia: Severely elevated triglyceride levels increase the risk of pancreatitis 4
- Presence of other metabolic disorders: Such as obesity, metabolic syndrome, and type 2 diabetes mellitus 3, 4, 7
- Family history: Certain genetic disorders can increase the risk of hypertriglyceridemia and its complications 3, 6
Management of Hypertriglyceridemia
The management of hypertriglyceridemia includes:
- Lifestyle modifications: Such as cessation of alcohol consumption, reduced intake of rapidly metabolized carbohydrates, weight loss, and blood sugar control 3, 4
- Medications: Such as fibrates, omega-3 fatty acids, and statins may be considered for patients with severely elevated triglyceride levels or high cardiovascular risk 3, 4, 6
- Double filtration plasmapheresis (DFPP): May be effective in reducing the risk of pancreatitis and cardiovascular disease in patients with severe hypertriglyceridemia 6