Triglycerides: Important Facts

By Danya Heeman


Many people are mindful about cholesterol but fewer people are knowledgeable about triglycerides. Triglycerides are one of the main risk factors for heart disease irrespective of so-called bad cholesterol or Low Density Lipoprotein (LDL) and other conventional risk factors.

Similar to elevated levels of fasting triglycerides, very high levels of non-fasting triglycerides may also increase the risk for coronary heart disease. There is growing interest in assessing triglycerides in individuals who have not fasted. The reasoning is that a non-fasting level of triglycerides may be more characteristic of the typical circulating level of triglyceride. Since majority of the day blood lipid levels reflect a non-fasting level.

High triglyceride is the third leading cause of acute pancreatitis after gallstone disease and alcohol. A triglyceride molecule is a combination of three molecules of fatty acids plus glycerides. It is the most common form of fat that humans digest. Changes in lifestyle habits are first-line therapy for all lipid disorders, including elevated triglycerides.

A regular exercise schedule consisting of at least 30 minutes of moderately intense physical activity (e.g., brisk walking), smoking cessation, and restriction of alcohol use and avoidance of high carbohydrate diets could help to reduce triglyceride levels in blood.

Patients with increased blood sugar level or uncontrolled diabetes may have higher level of triglycerides. Some drugs such as corticosteroids, protease inhibitors for HIV, beta blockers, and estrogens can increase blood triglyceride levels.

The American Heart Association (AHA), the US Department of Agriculture, and Health and Human Services advise a regular ingestion of fatty fish (salmon, tuna, herring, sardines, mackerel, and trout) that deliver omega-3 fatty acids (docosahexanoic acid [DHA] and eicosapentaenoic acid [EPA]).

Consumption of 8 ounces of fatty fish in a week provides an average of almost 500 mg/d DHA and EPA.

Treatment consisting of 4 g of omega-3 fatty acids per day resulted in a median reduction of triglycerides of almost 45%. For patients who have severe hypertriglyceridemia (equal or greater than 500mg/dl), therapeutic options recommend lowering triglycerides by including in the patient's diet 4g/d omega-3 fatty acids, fibrates, high doses of niacin and, if needed, high doses of statins.




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