Hypertriglyceridemia has been considered as a risk factor for cardiovascular diseases. However, triglyceride levels are influenced by many clinical and lipid risk factors. When triglyceride levels are adjusted by these variables, the effect of hypertriglyceridemia as a cardiovascular risk factor becomes minimal or negligible. Therefore, the association of hypertriglyceridemia with cardiovascular diseases is uncertain. The effect of triglyceride-lowering drugs on cardiovascular diseases is also unclear. These drugs failed to reduce cardiovascular events in relatively high risk patients with variable lipid profiles. However, subgroup analysis showed the cardioprotective effects in selected patients. It is clinically important whether a patient with hypertriglyceridemia should be treated with drug therapy or not. This paper discusses this issue based on limited data of published reports.
Cardiovascular Diseases* ; Drug Therapy ; Humans ; Hypertriglyceridemia* ; Risk Factors ; Triglycerides

Pancreatitis is a very rare adverse effect of quetiapine treatment, with only 5 cases of quetiapine-associated pancreatitis reported in the English literature to date. Herein, we report one patient who developed severe hypertriglyceridemia (>1000 mg/dL) after quetiapine administration, resulting in acute pancreatitis. An analysis of the underlying pathogenic mechanisms and a review of relevant literature are also presented. Clinicians should be aware of the potentially life-threatening metabolic disturbances and/or pancreatitis associated with quetiapine therapy.
Acute Disease ; Bipolar Disorder/*drug therapy/*psychology ; Dibenzothiazepines/*therapeutic use ; Humans ; Hypertriglyceridemia/*drug therapy/*psychology ; Pancreatitis/*drug therapy/*psychology

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.
Adult ; Biopsy ; Bone Marrow ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Hypertriglyceridemia ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Skin*

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.
Adult ; Biopsy ; Bone Marrow ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Hypertriglyceridemia ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Skin*

Antibodies, Monoclonal, Humanized/therapeutic use* ; Humans ; Hyperlipidemias ; Hypertriglyceridemia/drug therapy* ; Proprotein Convertases ; Subtilisins

BACKGROUND: The ciprofibrate, 3rd generation fibrate derivative, is known as an effective hypolipidemic drug in both hypercholesterolemia and hypertriglyceridemia. We studied the efficacy and side effects of ciprofibrate dmonotherapy in patients with primary type II and type IV hyperlipidemia. METHOD: Patients who showed 12-hours fasting serum total cholesterol level more than 240mg% and/or serum triglyceride level more than 250mg% were enrolled to diet therapy. After 12 weeks of diet therapy serum lipid profiles were checked and the drug therapy was considered according to the above mentioned guidelines. The ciprofibrate 100mg p.o qd was administrated and the patients had regular follow-up every 6 weeks for 12 weeks. RESULTS: The total study population was 32 patients. Fifteen patients were type II hyperlipidemia and seventeen patients were type IV hyperlipidemia. The drug was well tolerated in all patients. There was mild gastrointestinal side effects in 9% of study patients but no patients discontinued ciprofibrate due to side effects. There was mild and transient serum CK elevation less than 3 times of baslines in 5(15%) patients. The LFT, serum uric acid, BUN and creatinine level did not show any significant changes during therapy. Serum total cholesterol and apolipoprotein B level in patients with type II hyperlipidemia showed significant reduction after 6week of therapy. The mean reduction was 25% and 32% respectively. Serum triglyceride level in patients with type IV hyperlipidemia decreased by 55%. The reduction of total cholesterol more than 25% could be achieved in 50% of type II hyperlipidemia and the reduction of triglyceride more than 25% could be achieved in 93% of type IV hyperlipidemia. CONCLUSION: The ciprofibrate is effective and sage hypolidipemic drug in patients with primary type II and type IV hyperlipidemia.
Apolipoproteins ; Cholesterol ; Creatinine ; Diet Therapy ; Drug Therapy ; Fasting ; Follow-Up Studies ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Hypertriglyceridemia ; Triglycerides ; Uric Acid

OBJECTIVETo investigate the effect of micronized fenofibrate on vascular endothelial function in patients with hypertriglyceridemia.

METHODSUsing high-resolution ultrasound, we measured flow- and nitroglycerin-induced dilatation of the brachial artery in 30 patients with hypertriglyceridemia before and after treatment with micronized fenofibrate at a dose of 200 mg once daily for 4 weeks. Simultaneously, both serum lipid and plasma endothelin (ET) levels were determined.

RESULTSAfter micronized fenofibrate therapy, serum triglyceride (TG) levels decreased significantly (P < 0.05). Plasma ET levels also decreased markedly [(82.66 +/- 15.46) microg/L vs. (106.22 +/- 19.16) microg/L, P < 0.001]. Flow-induced vasodilatation was much improved (11.0% +/- 9.0% vs 2.7% +/- 2.0%, P < 0.01). However, no significant changes in vasodilatation occurred in response to nitroglycerin (16.2% +/- 6.0% vs 15.0% +/- 5.0%, P > 0.05) in patients with hypertriglyceridemia.

CONCLUSIONSMicronized fenofibrate can improve impaired endothelium-dependent vasodilatation in patients with hypertriglyceridemia. Improving endothelial function may also be the mechanism responsible for the beneficial effects of micronized fenofibrate.

Adult ; Endothelium, Vascular ; drug effects ; physiology ; Female ; Fenofibrate ; pharmacology ; therapeutic use ; Humans ; Hypertriglyceridemia ; drug therapy ; Male ; Middle Aged ; Vasodilation ; drug effects

Cardiovascular disease due to atherosclerosis is a leading cause of death around the world, including Singapore. Current treatment strategies primarily target low-density lipoprotein (LDL) cholesterol levels. Low levels of high-density lipoprotein (HDL) cholesterol and high triglyceride (TG) levels have been shown to increase the risk of coronary heart disease, but the clinical benefits of raising low HDL cholesterol have only been proven in a limited number of studies. This guide provides an approach on managing low HDL cholesterol levels in terms of lifestyle modifications and pharmacotherapy.
Coronary Disease ; prevention & control ; Drug Therapy, Combination ; Exercise ; Fenofibrate ; administration & dosage ; Humans ; Hypertriglyceridemia ; drug therapy ; therapy ; Hypoalphalipoproteinemias ; drug therapy ; therapy ; Hypolipidemic Agents ; administration & dosage ; Life Style ; Male ; Middle Aged ; Simvastatin ; administration & dosage

Purpose: In order to identify the stone risk factors for stone patients with hypertension, we analyzed the stone metabolic studies of stone patients with hypertension and stone patients without hypertension. Materials and Methods: Between January 1998 and December 2005, we analyzed 92 urinary calculi patients with hypertension, and we also 210 urinary calculi patients who had no history of hypertension as a control group. Hypertension was defined as systolic blood pressure >140 mmHg or a diastolic pressure >90mmHg or both, or those patients who were on drug therapy for hypertension. We evaluated such metabolic risk factors as calcium, sodium, potassium, chloride, uric acid, oxalate, phosphorus, the total urine volume and urine citrate level of the 24-hour urine collection, and the uric acid, calcium, phosphorus, cholesterol, triglyceride from the serum. Results: The mean age was 53.2+/-11.2 in the hypertensive group and 48.4+/-14.0 in the normotensive group. There were significant differences between the hypertensive group and the normotensive group for the body mass index (BMI) (28.7+/-0.9kg/m2 vs 25.1+/-1.1kg/m2, respectively), weight (73.2+/-3.2kg vs 67.4+/-2.1kg respectively) and urine calcium (262.4+/-21.7 mg/day vs 205.2+/-22.3mg/day respectively), uric acid (662.7+/-184.3mg/ day vs 578.3+/-179.2 mg/day respectively). Moreover, there were significant differences between the two groups for total cholesterol (198.5+/-47.4mg/dl vs 167.1+/-42.5 mg/dl respectively) and triglyceride (207.5+/-109.5mg/dl vs 160.8+/-107.1 mg/dl respectively). Conclusions: Our results suggest that higher urinary calcium excretion and higher uric acid excretion appear to be the characteristic risk factors in the hypertensive group. Hypercholesterolemia, hypertriglyceridemia and an excessive BMI are also related to stone patients with hypertension.
Blood Pressure ; Body Mass Index ; Calcium ; Cholesterol ; Citric Acid ; Drug Therapy ; Humans ; Hypercholesterolemia ; Hypertension* ; Hypertriglyceridemia ; Phosphorus ; Potassium ; Risk Factors* ; Sodium ; Triglycerides ; Uric Acid ; Urinary Calculi ; Urine Specimen Collection

Heparin and/or insulin stimulate lipoprotein lipase and are known to decrease serum triglyceride level. However, their efficacy in hypertriglyceridemia-induced acute pancreatitis in nondiabetic patients is not well documented. We report a case of hypertriglyceridemia-induced pancreatitis in 43-year-old nondiabetic woman in whom treatment with insulin was accompanied by reduction in serum triglyceride level and the resolution of pancreatitis. She presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. Her medical history was unremarkable. There was no history of alcohol consumption, and biliary imaging was not remarkable. Subsequent laboratory investigation revealed marked hypertriglyceridemia (1,951 mg/dL), impaired fasting glucose, and normal HbAlc level. The Ranson's score and APATCH II score were 1 and 4. Abdominal CT showed diffuse enlargement of pancreas, peripancreatic fat infiltration, and multiple fluid collections around the pancreas. We treated the patient with the infusion of 5% dextrose and 1.5 unit/hr regular insulin to reduce serum triglyceride level. The level of serum triglyceride was decreased to 305 mg/dL on day 5. During the remainder of hospitalization, her clinical symptoms and laboratory values gradually improved.
Acute Disease ; Adult ; Diabetes Mellitus/diagnosis ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Hypertriglyceridemia/*complications ; Insulin/*therapeutic use ; Pancreatitis/*drug therapy/etiology ; Severity of Illness Index ; Tomography, X-Ray Computed