Терапевтический архив (Apr 2010)

Diagnosis of moderate and high hypertriglyceridemia in patients in polyclinic practice: primary and secondary lipid metabolic disturbances

  • Tat'yana Alekseevna Rozhkova,
  • Vladimir Nikolaevich Titov,
  • Vera Alekseevna Amelyushkina,
  • Elena Borisovna Yarovaya,
  • Pavel Prokop'evich Malyshev,
  • Aleksey Nikolaevich Meshkov,
  • Valeriy Vladimirovich Kukharchuk,
  • T A Rozhkova,
  • V N Titov,
  • V A Amelyushkina,
  • E B Yarovaya,
  • P P Malyshev,
  • A N Meshkov,
  • V V Kukharchuk

Journal volume & issue
Vol. 82, no. 4
pp. 10 – 17

Abstract

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Aim. To define clinical and biochemical differences in groups of patients with moderate (m4.5 mmol/l and high (more than 4.5 mmol/l) blood triglyceride (TG) levels. To define the markers of biochemical and lipid parameters that could specify an algorithm for the differential diagnosis and treatment of different forms of hypertriglyceridemia. Subjects and methods. Patients (96 (54%) females) aged 12 to 71 years (median 50 years; quartiles, 41-61 years) with a TG level of more than 2.3 mmol/l and the following diseases: coronary heart disease (CHD) (44.8%), myocardial infarction (13.5%), arterial hypertension (87.9%), xanthomas (36.5%), and a family history of diseases (51%). The diagnosis of hyperlipidemia included a classical algorithm for clinical, biochemical, and clinicogenealogical examinations. Extended biochemical blood analysis, the determination of lipoprotein cholesterol (C), TG, low-density lipoprotein C, lipid electrophoresis, and assay of apolipoproteins A1, B-100, E, and C3 were made. Results. The groups with moderate (m4.5 mmol/l and high (more than 4.5 mmol/l) blood triglycerides showed no differences in age and gender, systolic and diastolic blood pressures, the incidence of coronary heart disease, arterial hypertension, peripheral artery atherosclerosis, cardiac arrhythmias, and xanthomas. There was a significant correlation of high TG levels with smoking (a risk factor) and with the indicators of other metabolic disturbances - total C, chylomicrones, lipoprotein(a), LP-E-total, LP B:E, LP-C3-total, and LP-C3, which determined the impact of nutrition (and the development of pancreatitis), but also had a hereditary predisposition through the polygenic mechanisms of gene expression under the influence of a number of factors. Conclusion. Higher TG levels correlated with the parameters, the diagnosis of which makes it possible to reveal additional metabolic disturbances via environmental and polygenic mechanisms.

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