Which disorders should be included in the differential diagnoses of hypertriglyceridemia (high triglyceride levels)?

Updated: Jul 23, 2021
  • Author: Mary Ellen T Sweeney, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

When triglycerides are noted to be elevated, always check a fasting blood sugar and HbA1c to rule out uncontrolled diabetes—one of the most frequent causes of hypertriglyceridemia. Management of this condition may make medication to lower the triglycerides unnecessary or, at least, make it easier to normalize.

A diet high in refined carbohydrates can cause hypertriglyceridemia. Although cakes, candy, cookies, etc, are an obvious source, the quantity of liquid calories (nondiet soda, juice, alcohol) should also be determined.

In addition, consider conditions such as hypertriglyceridemia with elevations of very low-density lipoprotein (VLDL) with or without chylomicronemia, as well as mixed hyperlipidemia (type IIb hyperlipidemia) with elevations of both low-density lipoprotein (LDL) and VLDL. Note that use of oral contraceptives, beta-blockers, and thiazide diuretics can also raise plasma triglyceride and VLDL levels.

First-degree relatives should be screened for hyperlipidemia.


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