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  1. 1. HypertriglyceridemiaMade by : khloud511@yahoo.com
  2. 2. Hypertriglyceridemiahypertriglyceridemia denotes high bloodlevels triglycerides.It has been associated with atherosclerosis,even in the absence ofhypercholesterolemia.It can also lead to pancreatitis in excessiveconcentrations (i.e. when the triglycerideconcentration is greater, and often verymuch greater, than 1000 mg/dl or
  3. 3. Signs and symptomsModestly elevated triglyceride levels do notlead to any physical symptoms. Higher levels are associated with lipemiaretinalis (white appearance of the retina),Eruptive xanthomas (small lumps in theskin, sometimes itchy)
  4. 4. Causes:A.Enzyme dependentB.Non enzyme dependent ( other causes )A. Enzyme dependent :1. Lipoprotein lipase deficiency2. Lysosomal acid lipase deficiency
  5. 5. Lipoprotein lipase deficiency(known as chylomicronemia)chylomicronemia and hyperlipoproteinemia typeIa is caused by a mutation in the gene whichcodes lipoprotein lipase.Lipoprotein lipase (Lps):is a member of the lipase gene family, whichincludes pancreatic lipase, hepatic lipase, andendothelial lipase.It is a water soluble enzyme that hydrolyzestriglycerides in lipoproteins, such as thosefound in chylomicrons and very low-densitylipoproteins (VLDL), into two free fatty acidsand one monoacylglycerol molecule.
  6. 6. 2.Lysosomal Acid Lipase Deficiency :happens when the body does not produceenough active LAL enzyme.This enzyme plays an important role in breakingdown fatty material (cholesteryl esters andtriglycerides) in the body.The lack of the LAL enzyme can lead to abuild-up of fatty material in a number of bodyorgans including the liver, spleen, gut, in thewall of blood vessels and other importantorgans.
  7. 7. Abnormalities that a person may havein(Cholesteryl Ester Storage Disease) include:A high cholesterol and high triglyceride levelA high bad cholesterol ( LDL)A very low good cholesterol (HDL)Unexplained hepatomegaly (liver enlargement)Elevated liver enzymes (a marker of liverdamage)Unexplained fat or lipid material in the liverUnexplained chronic liver disease that may begetting worse over time
  8. 8. B. Other causes :High carbohydrate dietIdiopathicObesityDiabetes mellitus and insulin resistance - it isone of the defined components of metabolicsyndromeExcess alcohol intake
  9. 9. renal failure, Nephrotic syndromeGenetic predisposition; some forms of familialhyperlipidemia such as familial combinedhyperlipidemiaSystemic Lupus Erythematosus Glycogenstorage disease type 1.
  10. 10. TreatmentTreatment of hypertriglyceridemia is byrestriction of carbohydrates and fat in the diet.As well as with niacin, fibrates and statins(three classes of drugs).Increased fish oil intake may substantiallylower an individuals triglycerides
  11. 11. Note:Niacin (also known as vitamin B3, nicotinicacid and vitamin PP) blocks the breakdownof fats, it causes a decrease in free fatty acidsin the blood and, as a consequence,decreases the secretion of VLDL andcholesterol by the liver.Fibrates are a class of amphipathic carboxylicacids used in accessory therapy in manyforms of hypercholesterolemia, usually incombination with statins
  12. 12. Statins (or HMG-CoA reductase inhibitors)are a class of drugs used to lower cholesterollevels by inhibiting the enzyme HMG-CoAreductase, which plays a central role in theproduction of cholesterol in the liver.preventionOmega-3 fatty acid supplementation in theform of fish oil has been found to be effectivein decreasing levels of triglycerides and allcardiovascular events by 19% to 45%