Isolated Triglyceridemia
نویسنده
چکیده
The various forms of hyperlipoproteinemia used to be designated type I to type V, depending on whether chylomicron triglyceride , VDRL triglyceride or both were elevated and whether LDL cholesterol was or not raised as well, has fallen into disuse. Now we distinguish : [1] Combined hyperlipidemia if triglycerides and LDL cholesterol are elevated. [2] Isolated moderate or severe hypertriglyceridemia if triglycerides are raised but LDL cholesterol is normal [3] High LDL cholesterol with normal triglycerides [4] Low HDL cholesterol with or without other abnormalities. By definition all patients with forms of moderate pure hypertriglyceridemia have a normal LDL cholesterol level, but that is not to say that all patients with moderate hypertriglyceridemia are the same.There are two forms :one with a normal apoB and one with an elevated apoB. The distinction is important as several studies have shown that risk is markedly increased in the latter only. Unfortunately, the two forms can not be distinguished accurately by measurement of lipid values. Thus many causes of hypertriglyceridemia exist, and not all hypertriglyceridemias are associated with increased cardiovascular risk. Clinicians have several tools to assess risk in individual patients, including nonHDL cholesterol levels, the triglyceride-to-HDL ratio, apoprotein B levels and lipoprotein particle subfractionation. Most important, however, is interpretation of triglyceride levels in the overall clinical context.
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