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Severe hypertriglyceridemia (sHTG) has many causes

For most people with sHTG, a combination of factors can affect the production and/or clearance 
of plasma triglycerides (TGs).1

Plasma levels of TG are largely determined by:1

  • The production of very low-density lipoproteins (VLDL) and chylomicrons, which carry most plasma TGs
  • The removal of TGs from the circulation by lipolysis

Therefore, elevated TG levels may arise from increased VLDL production, increased chylomicron production, and/or reduced clearance of these lipoproteins by lipolysis or the liver.  If TG levels exceed 500 mg/dL (sHTG), the dominant metabolic abnormality is reduced lipolysis of circulating VLDL and chylomicrons.1

Diagram showing the production of VLDL and the removal of TGs from the circulation by lipolysis

Most cases of sHTG have a genetic component, but secondary factors usually contribute.23

In some cases, genetic factors may explain high TG levels that are refractory to lifestyle changes and guideline-directed therapy.4,12

Lifestyle and medical factors icon

Lifestyle and Medical Factors9,4,2

Medications icon

Medications9,4,2

Genetic causes icon

Genetic Causes4

learn about the clinical presentation of shtg >

REFERENCES

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