CoChat
Sign Up
Cited by 110Lipid metabolism and disordersLipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and Lipoproteins

The Diagnosis and Treatment of Hypertriglyceridemia

Open access
Parhofer, Klaus G., Laufs, Ulrich·2019·Deutsches Ärzteblatt international
DOI 10.3238/arztebl.2019.0825PMC PMC6962767
Open this paper in CoChat — free accountOpen PDF

Abstract

A pproximately 15% to 20% of patients visiting a medical practice are diagnosed with hypertriglyceridemia-frequently as an incidental finding (1).Given the increases in the prevalence of diabetes, metabolic syndrome, and obesity, the prevalence of hypertriglyceridemia is likely to increase too.The severity of hypertriglyceridemia (Table 1) varies widely, and to date no uniform classification of the condition has been established.To further complicate the matter, triglyceride (TG) levels can show intraindividual fluctuation.Most affected persons (80-90%) have moderately increased TG levels, i.e., between 150 mg/dL (1.7 mmol/L) and 400 mg/dL (4.6 mmol/L).In a small proportion of patients (approximately 15%), TG levels range between 400 mg/dL and 1000 mg/dL (4.6-11.4mmol/L); occasionally, significantly higher levels are found (e1).In very rare cases, TG levels above 15 000 mg/dL (170 mmol/L) have been identified. SummaryBackground: Hypertriglyceridemia affects 15-20% of the adult population and is associated with overweight, metabolic syndrome, and diabetes mellitus.It is often discovered incidentally.Methods: This review is based on pertinent publications retrieved by a selective literature search, including current guidelines on hypertriglyceridemia.Results: Elevated triglyceride (TG) levels are causally linked to cardiovascular disease; TG levels above 1000 mg/dL (11.4 mmol/L) can induce acute pancreatitis.The individual risk of cardiovascular disease and of pancreatitis must be estimated in order to decide whether, and how, hypertriglyceridemia should be treated.Lifestyle modifications (cessation of alcohol consumption, reduced intake of rapidly metabolized carbohydrates), weight loss, and blood sugar control are the most effective ways to lower TG levels.The need to lower the low-density lipoprotein (LDL) concentration must be determined on the basis of the cardiovascular risk, independently of the success of the lifestyle changes.Few patients need specific drug treatment to lower the TG level.Fibrates can lower TG concentrations, but their efficacy in combination with statins has not been clearly shown in endpoint studies.A daily dose of 2-4 g omega-3 fatty acids can also lower TG levels.To date, only a single large-scale randomized, blinded trial has shown the efficacy of 4 g of eicosapentaenoic acid ethyl ester per day in lowering the risk in high-risk patients (number needed to treat = 21).Patients with the very rare purely genetic types of hypertriglyceridemia (familial chylomicronemia syndrome) should be treated in specialized outpatient clinics.Conclusion: Hypertriglyceridemia is causally linked to cardiovascular disease and pancreatitis.Lifestyle modifications play a paramount role in its treatment.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3238/arztebl.2019.0825

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Triglycerides may be lowered by at least 50% to 70% in response to weight loss; however, the response may be variable.

    “Triglycerides may be lowered by at least 50% to 70% in response to weight loss; however, the response may be variable (54,56).”

    From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [56]

    Table 3 reports that weight loss lowers triglycerides variably, by up to 70%; the Remarks also describe substantial differences between individuals. The source does not establish a reduction of at least 50%, so the claimed 50%–70% range overstates what it reports. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Some patients may have pronounced triglyceride lowering with only a few kilograms of weight loss, whereas other patients may have a minor triglyceride-lowering response despite a significant weight loss.

    “Some patients may have pronounced triglyceride lowering with only a few kilograms of weight loss, whereas other patients may have a minor triglyceride-lowering response despite a significant weight loss (56).”

    From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [56]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. M E D I C I N E Deutsches Ärzteblatt International | Dtsch Arztebl Int 2019; 116: 825-32 | Supplementary material I eReferences
  2. Parhofer KG, Barrett PH, Schwandt P: Atorvastatin improves post- prandial lipoprotein metabolism in normolipidemlic subjects. J Clin Endocrinol Metab. 2000; 85: 4224-30.

Cited by

Sorted by citations

Related

Authors
Parhofer, K. G., & Laufs, U.
Affiliations
University Hospital Leipzig (DE)
Corresponding author
Parhofer, Klaus G.
ORCID
Venue
Deutsches Ärzteblatt international
Publisher
Deutscher Arzte-Verlag GmbH
Published
2019-12-06
Volume
116
Issue
49
Pages
825-832
ISSN
1866-0452 (ISSN-L)
DOI
10.3238/arztebl.2019.0825
PMC
PMC6962767
OpenAlex
W2990258037
Cited by
110
References
56
Citations by year
2026: 7 · 2025: 20 · 2024: 27 · 2023: 18 · 2022: 17 · 2021: 14 · 2020: 6 · 2018: 1
FWCI
1.67
Type
journal article
Language
de
Open access
Locations
  • Deutsches Ärzteblatt international (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
hypertriglyceridemia, triglyceride levels, cardiovascular risk, acute pancreatitis, lifestyle modification, fibrates, statins, omega-3 fatty acids, LDL cholesterol, metabolic syndrome, diabetes mellitus, obesity, triglyceride-lowering therapy, treatment guidelines, weight loss
MeSH terms
Cardiovascular Diseases, Humans, Pancreatitis, Hypertriglyceridemia, Randomized Controlled Trials as Topic, Practice Guidelines as Topic, Risk Reduction Behavior

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review