Thursday, April 25, 2013

Triglycerides: Important Facts

By Artemis Yazbeck

Most people are familiar with cholesterol but are less knowledgeable about triglycerides. Elevated blood triglyceride level is a significant risk factor for coronary heart disease irrespective of so-called bad cholesterol (Low Density Lipoprotein [LDL]) and other established 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.

Increased triglycerides are the third important cause of acute pancreatitis after gallstone disease and alcohol. A triglyceride molecule is a blend of three molecules of fatty acids plus glycerides. It is the most common form of fat that humans digest. Alterations in daily lifestyle practices are first-line therapy for all cholesterol and lipid related issues, including raised triglycerides.

A consistent exercise plan containing of at least 30 minutes of moderately intense physical activity (e.g., brisk walking), smoking cessation, curbing alcohol use and avoidance of high carbohydrate diets could aid to lessen 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, the US Department of Agriculture, and Health and Human Services recommend regular consumption of fatty fish (salmon, tuna, herring, sardines, mackerel, and trout) that provide omega-3 fatty acids (docosahexanoic acid [DHA] and eicosapentaenoic acid [EPA]).

Eating 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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