Triglycerides, Serum

The maximum changes achieved in a study were -20% total serum cholesterol, -40% serum triglycerides and +15% HDL-cholesterol [2]. However, there are considerable short- and long-term side-effects. The treatment should therefore be monitored by a doctor. 

While the fibric acid derivatives have antihyperlipidemic effects, their use varies depending on the drug. For example, Clofibrate (Atromid-S) and gemfibrozil (Lopid) are used to treat individuals with very high serum triglyceride levels who present a risk of abdominal pain and pancreatitis and who do not experience a response to diet modifications. Clofibrate is not used for the treatment of other types of hyperlipidemia and is not thought to be effective for prevention of coronary heart disease. Fenofibrate (Tricor) is used as adjunctive treatment for the reduction of LDL, total cholesterol, and triglycerides in patients with hyperlipidemia. 

Niacin is used as adjunctive therapy for the treatment of very high serum triglyceride levels in patients who present a risk of pancreatitis (inflammation of the pancreas) and who do not experience an adequate response to dietary control. 

Monitor serum triglyceride levels with prolonged infusions... 

After assessment and control of LDL cholesterol, patients with serum triglycerides of 200 to 499 mg/dL (2.26 to 5.64 mmol/L) should be assessed for atherogenic dyslipidemia (low HDL cholesterol and increased small-dense LDL particles) and metabolic syndrome. 

Combination drug therapy is an effective means to achieve greater reductions in LDL cholesterol (statin + ezetimibe or bile acid resin, bile acid resin + ezetimibe, or three-drug combinations) as well as raising HDL cholesterol and lowering serum triglycerides (statin + niacin or fibrate). 

If serum triglycerides are greater than 400 mg/dL (4.52 mmol/L), this formula becomes inaccurate and LDL cholesterol must be directly measured.3... 

Patients with serum triglycerides from 150-500 mg/dL (1.70-5.65 mmol/L) and serum HDL cholesterol less than 40 mg/dL (1.04 mmol/L) may have metabolic syndrome and need to be evaluated. 

Patients with extremely elevated serum triglycerides (greater than 1,000 mg/dL [11.3 mmol/L]) can develop pancreatitis and tuberoeruptive xanthomas. 

Niacin can be combined with a fibrate in patients with high elevations in serum triglycerides. The combination may increase the risk of myopathy compared to either agent alone. 

Clofibrate (91) has been in clinical use for several years as a serum triglyceride lowering agent. This drug is an important hypocholesteremic... 

Tibric acid (10), interestingly, has the m-carboxysulfonamido functionality but its activity is expressed, instead, as suppression of serum triglyceride levels. In its reported preparation, chloro-sulfonic acid treatment converts 2-chlorobenzoic acid to chlorosulfonate 9, which readily forms the hypolipidemic agent tibric acid (10) on reaction with... 

High serum triglycerides (see Table 9-1) should be treated by achieving desirable body weight, consumption of a low saturated fat and cholesterol diet, regular exercise, smoking cessation, and restriction of alcohol (in selected patients). 

Increases in serum lipids and glucose appear to be transient and of little clinical importance. /J- Blockers increase serum triglyceride levels and decrease high-density lipoprotein cholesterol levels slightly. /1-Blockers with -blocking properties (carvedilol and labetalol) do not affect serum lipid concentrations. 

Serum triglyceride—until stable on maximum dose of IV fat emulsion... 

Nitrogen balance Prealbumin or transferrin Serum triglyceride... 

Some SGAs and phenothiazines cause elevations in serum triglycerides and cholesterol. The risk for this effect may be less with risperidone, ziprasidone, and aripiprazole. 

Mosca L, Harper K, Sarkar S, O Gorman J, Anderson PW, Cox DA, Barrett-Connor E (2001b) Effect of raloxifene on serum triglycerides in postmenopausal women influence of predisposing factors for hypertriglyceridemia. Clin Ther 23 1552-1565... 

Perhaps the most hopeful sign of progress is the belated recognition of "paradoxical" reactions to the lipid-lowering diets that have been widely used for decades. For example, researchers at the South-Western Medical Center in Dallas repeatedly find "marked individual variations in response to the diet." In many persons these diets show little benefit, or increase LDL cholesterol, serum triglycerides, or... 

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