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Hypertriglyceridemi

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Definition:
Hypertriglyceridemi är ett tillstånd med förhöjda triglyceridvärden (>1,7 mmol/L) och en indikator på ökad risk för hjärt- och kärlsjukdom.
Förekomst:
Ungefär en tredjedel av vuxna har triglycerider >1,7 mmol/L.
Symtom:
Inga. Värden >10 mmol/L kan utlösa akut pankreatit.
Fynd:
I vissa fall kan xanthom/xanthelasma observeras.
Diagnos:
Mild-måttlig hypertriglyceridemi >1,7 mmol/L till 10 mmol/L, svår hypertriglyceridemi: >10 mmol/L.
Behandling:
Levnadsvaneförändringar. Läkemedelsbehandling bör övervägas vid högriskpatienter med triglycerider >2,3 mmol/L trots levnadsvaneförändringar.
  1. Jeppesen J, Hein HO, Suadicani P et al. Triglyceride concentration and ischemic heart disease. An eight-year follow-up in the Copenhagen Male Study. Circulation 1998; 97: 1029-36. PubMed  
  2. Kotseva K, Wood D, De Backer G, et al. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16:121–137. PMID:19287307. PubMed  
  3. Citkowitz E. Hypertriglyceridemia. eMedicine, June 3, 2004; www.emedicine.com.
  4. Catapano A, Graham I, De Backer G et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37:2999-3058. PubMed  
  5. Leaf DA. Hypertriglyceridaemia. BMJ Best Practice, last updated May 2018. bestpractice.bmj.com  
  6. Sweeney MET. Hypertriglyceridemia. Medscape. Last updated May 30, 2014. http://emedicine.medscape.com/article/126568-overview. emedicine.medscape.com  
  7. Beigneux AP, Miyashita K, Ploug M, et al. Autoantibodies against GPIHBP1 as a cause of hypertriglyceridemia. N Engl J Med 2017: 376:1647-58. doi: 10.1056/NEJMoa1611930 DOI  
  8. Janusinfo, Region Stockholm. Avancerade lipidrubbningar – utredning och behandlings­rekommendation. 2022-01-10 (Hämtad 2022-02-14). janusinfo.se  
  9. Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014 Aug 16;384(9943):626-35. doi: 10.1016/S0140-6736(14)61177-6.
  10. Ballantyne CM, Olsson AG, Cook TJ et al for the Scandinavian Simvastatin Survival Study (4S) Group. Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S. Circulation 2001; 104: 3046-51. Circulation  
  11. Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease: the Benzafibrate Infarction Prevention (BIP) Study. Circulation 2000; 102: 21-7. Circulation  
  12. Zambon A, Brown BG, Deeb SS, Brunzell JD. Genetics of apolipoprotein B and apolipoprotein AI and premature coronary artery disease. J Intern Med 2006; 259: 473-80. PubMed  
  13. Khera AV, Won H-H, Peloso GM, et al. Association of rare and common variation in the lipoprotein lipase gene with coronary artery disease. JAMA 2017; 317: 937-46. doi: 10.1001/jama.2017.0972 DOI  
  14. Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. Eur Heart J (2016) 37 (39): 2999-3058. PMID:27567407. PubMed  
  15. Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2011; 123: 2292-333. Circulation  
  16. Ellingsen I, Hjermann I, Abdelnoor M, Hjerkinn EM, Tonstad S. Dietary and antismoking advice and ischemic heart disease mortality in men with normal or high fasting triacylglycerol concentrations: a 23-y follow-up study. Am J Clin Nutr 2003; 78: 935-40. PubMed  
  17. Att förebygga aterosklerotisk hjärt-kärlsjukdom med läkemedel – behandlingsrekommendation. Information från Läkemedelsverket 2014;25(5):20–33.
  18. Aung T, Halsey J, Kromhout D, et al. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol. 2018 Mar 1;3(3):225-234. PMID: 29387889. PubMed  
  19. Bhatt DL, Steg G, Miller M, et al for the REDUCE-IT Investigators. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med 2019; 380: 11-22. pmid:30415628 PubMed  
  20. Toskes PP. Hyperlipemic pancreatitis. Gastroenterol Clin North Am 1990; 19: 783-91. PubMed  
  21. Freiberg JJ, Tybjærg-Hansen A, Jensen JS, Nordestgaard BG. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA 2008; 300: 2142-52. Journal of the American Medical Association  
  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas