From the Guidelines
Total triglycerides are a measurement of the total amount of triglycerides in your blood, which are a type of fat that serves as an important source of energy, and should be managed through lifestyle modifications and medications to reduce the risk of heart disease, stroke, and pancreatitis, as recommended by the most recent guidelines 1.
Definition and Measurement
Total triglycerides are typically measured as part of a standard lipid panel blood test, often after fasting for 9-12 hours.
Normal and Abnormal Levels
A normal triglyceride level is less than 150 mg/dL, while borderline high levels range from 150-199 mg/dL, high levels from 200-499 mg/dL, and very high levels at 500 mg/dL or above.
Risk Factors and Management
Elevated triglycerides can increase your risk of heart disease, stroke, and pancreatitis, and are often associated with other factors such as diabetes, obesity, hypertension, high LDL cholesterol, and low HDL cholesterol 1.
Lifestyle Modifications
To maintain healthy triglyceride levels, focus on lifestyle modifications including:
- Limiting added sugars and refined carbohydrates
- Reducing alcohol consumption
- Maintaining a healthy weight
- Exercising regularly
- Eating more omega-3 fatty acids from sources like fatty fish
Medications
If levels remain high despite lifestyle changes, medications such as fibrates, niacin, or omega-3 fatty acid supplements may be prescribed by your healthcare provider, as recommended by the American College of Cardiology/American Heart Association task force on practice guidelines 1.
Recent Guidelines
The most recent guidelines from the Diabetes Care journal recommend intensifying lifestyle therapy and optimizing glycemic control for patients with elevated triglyceride levels, and focusing on a Mediterranean or Dietary Approaches to Stop Hypertension (DASH) eating pattern, reducing saturated and trans fat intake and increasing plant stanols/sterols, n-3 fatty acids, and viscous fiber intake 1.
From the FDA Drug Label
The lipid-modifying effects of fenofibric acid seen in clinical practice have been explained in vivo in transgenic mice and in vitro in human hepatocyte cultures by the activation of peroxisome proliferator activated receptor α (PPARα) Through this mechanism, fenofibrate increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein C-III (an inhibitor of lipoprotein lipase activity) The resulting decrease in TG produces an alteration in the size and composition of LDL from small, dense particles (which are thought to be atherogenic due to their susceptibility to oxidation), to large buoyant particles. Fenofibric acid, the active metabolite of fenofibrate, produces reductions in total cholesterol, LDL cholesterol, apolipoprotein B, total triglycerides and triglyceride rich lipoprotein (VLDL) in treated patients.
Total triglycerides refer to the total amount of triglycerides in the blood, which are a type of fat (lipid) found in the blood. They are an important measure of cardiovascular health, and elevated levels of total triglycerides are associated with an increased risk of cardiovascular disease.
In the context of the provided drug labels, total triglycerides are mentioned as a parameter that is reduced by fenofibrate therapy 2 2. However, the exact definition or explanation of what constitutes total triglycerides is not provided in the labels.
It is essential to note that the provided information is based on the drug labels and may not be a comprehensive or definitive explanation of total triglycerides. For a more detailed understanding, it is recommended to consult a medical professional or a reliable medical resource.
From the Research
Definition of Total Triglycerides
- Total triglycerides refer to the total amount of triglycerides in the blood, which are a type of fat (lipid) found in the blood.
- Triglycerides are formed from glycerol and three fatty acid molecules, and they are an important source of energy for the body 3, 4.
Importance of Triglycerides
- Elevated triglyceride levels are independently associated with cardiovascular disease (CVD) risk, and severe hypertriglyceridemia is a risk factor for acute pancreatitis 3, 5.
- Triglyceride-rich lipoproteins (TRL) and their remnants are important contributors to atherosclerotic cardiovascular disease (ASCVD) 5, 6.
Measurement and Management of Triglycerides
- Triglycerides are measured as part of routine lipid profiles, and their relationship to CVD risk has been established through epidemiological studies and meta-analyses of intervention trials 6, 7.
- Reduction of severely elevated triglycerides is important to avert or reduce the risk of pancreatitis, and guidelines recommend the use of triglyceride-lowering agents such as fibrates, niacin, and long-chain omega-3 fatty acids 3, 4, 5.
Treatment Options for Hypertriglyceridemia
- Statins are the first line of therapy for the management of mild to moderate hypertriglyceridemia, but individuals with hypertriglyceridemia may need additional reduction in triglyceride-rich lipoproteins and remnant particles to further reduce residual CVD risk 3.
- Prescription omega-3 fatty acids, fibrates, and niacin are effective alternatives for reducing triglyceride levels, and their use is recommended in guidelines for the management of severe hypertriglyceridemia 3, 4, 5.