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Metabolic Laboratory Data
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Pseudohypoglycemia can occur if there are confounding substances in the plasma. Severe hypertriglyceridemia is a cause of this, as is elevated paraprotein levels from conditions like lymphoma. We should also mention that red and white cells continue to metabolize glucose in the sample tube. So, the blood sugar will be low when the tube is left unspun at room temperature (glucose drops ~7 mg/dL/hour) or when there is polycythemia or CLL.
Diabetes Mellitus, Obesity, Lipoprotein Disorders and other Metabolic Diseases
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Plasma lipid and lipoprotein disorders – the dyslipidaemias – are associated with increased risks of atherosclerosis-related disease, particularly coronary artery disease (CAD). Severe hypertriglyceridaemia is a risk factor for pancreatitis.
Omega-3 Fatty Acids and NO from Flax Intervention in Atherosclerosis and Chronic Systemic Inflammation
Published in Robert Fried, Richard M. Carlton, Flaxseed, 2023
Robert Fried, Richard M. Carlton
Triglycerides are composed of glycerol and three fatty acids. They are the main constituent of body fat. They are present in blood and enable the bidirectional transfer of adipose fat and blood glucose from the liver. In most people who do not have a genetic predisposition to hypertriglyceridemia, it is commonly associated with obesity, type 2 diabetes and metabolic syndrome.
Long-term safety and effectiveness of biosimilar insulin glargine in Japanese patients with diabetes mellitus in routine clinical practice: results of a post-marketing safety study
Published in Current Medical Research and Opinion, 2020
Tomotaka Shingaki, Kentaro Taki, Momoha Koyanagi, Soshi Nagaoka, Kenichi Yoshizawa, Norika Oki, Aki Yoshikawa, Takeshi Imaoka
Serum lipids are known to be significantly impacted by insulin24. Hypertriglyceridemia is a common serum lipid abnormality associated with diabetes, due either to insulin resistance or deficiency. Recent evidence from a study with a Japanese cohort suggested triglycerides are a leading predictor of cardiovascular risk in patients with diabetes, comparable to HbA1c and stronger than hyperglycemia as predictors, even for patients with very high blood glucose levels. Cardiovascular disease is further exacerbated by kidney disease, which is also a common comorbidity of diabetes, and hypertriglyceridemia contributes to both kidney and widespread vascular endothelial damage. Lowering triglyceride levels is therefore an indicator of metabolic improvement in patients with diabetes, and may lower cardiovascular and kidney risks.
Eruptive xanthoma associated with severe hypertriglyceridemia and poorly controlled type 1 diabetes mellitus
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Recognizing eruptive xanthomas as a clinical sign for underlying systemic diseases is an important step to evaluate and manage these conditions. In short term, one major reason to treat hypertriglyceridemia is to prevent acute pancreatitis, which has been intimately associated with severe hypertriglyceridemia. Another potential important risk associated with hypertriglyceridemia is a cardiovascular disease. The relationship between triglycerides and cardiovascular disease is less clear. Therefore, additional lab tests can further help to identify patients with a higher risk to develop cardiovascular disease. As noted in our patient, apo E genotype of E3/E4 has been associated with greater risk of developing heart disease, high LDL cholesterol and triglyceride level. Patents with the E3/E4 genotype are known to respond poorly to statins, but well on a low-fat diet [5]. The elevated Apo B/A1 ratio in our patient is another indicator to support a greater risk of cardiovascular disease. As shown in the global INTERHEART study, ApoB/A1 ratio is the most important risk factor for myocardial infarction in all geographic regions [6].
Current pharmacotherapeutic options for primary dyslipidemia in adults
Published in Expert Opinion on Pharmacotherapy, 2019
Arrigo F.G. Cicero, Matteo Landolfo, Fulvio Ventura, Claudio Borghi
Hypercholesterolemia is the only reversible CV risk factor with a direct and linear relationship between its reduction and the clinical efficacy without apparent J-curve effect. This applies also to serum TG even if to a lesser extent of confidence. An overwhelming amount of data supports the use of the LDL-C lowering drugs (statins, ezetimibe and PCSK9 inhibitors) in order to reduce the CV risk. Their efficacy is largely proportional to their ability to reduce the LDL-C plasma level, in agreement with the LDL-C targets based on the individual CV risk and the results of randomized clinical trials. On the other side, a growing body of epidemiological and genetic evidence supports the role of hypertriglyceridemia as an additional risk factor for CV disease. The overall impact of serum TG is probably weaker than LDL-C in the general population, but they could exert a primary role in some sub-populations of high-risk patients (e.g. diabetes and metabolic syndrome). A recent very large study published in JACC has clearly demonstrated an absolute increase in the risk of MACE in patients with high TGs levels not eligible for statin treatment according to risk cards or guidelines [114]. Most of the trials carried out with TG lowering drugs have given limited results in term of CV risk reduction, probably because of the heterogeneity of the patients and the lack of high-TG as inclusion criteria. Anyway, the recent data from the REVEAL-IT trial have demonstrated the importance of treatment in patients with high TG levels and have raised new interest in TG lowering treatment for CV risk reduction.