High triglycerides refer to the concentration of triglycerides in the blood being greater than the normal range. Its occurrence is mainly related to heredity, bad living habits, and primary diseases of the body. High triglycerides usually do not have obvious symptoms, but long-term elevated triglycerides may cause patients to develop xanthomas, obesity, overweight, etc. Some patients may also have chylomas when blood is drawn (i.e. a layer of milk-like oil floating on the blood). When triglyceride levels rise to a certain level, it may cause acute pancreatitis, causing patients to experience symptoms such as abdominal pain, nausea, and vomiting.
Epidemiology
Infectiousnone
symptom
Typical manifestations
1. Mild elevation of triglycerides does not cause obvious symptoms;
2. Long-term elevated triglycerides will cause xanthomas to appear on the patient’s eyelids, and some patients may also become overweight or obese;
3. Severely elevated triglycerides may also cause chylomicronization during blood draw, i.e. milk-like oil appears in the blood.
4. High triglycerides may cause complications such as blurred vision, decreased vision, dizziness, headache, lack of mobility, chest tightness, palpitations, and asthma.
reason
Overview
Abnormalities in lipid sources, lipoprotein synthesis, key enzymes in the metabolic process, and receptor pathway disorders in the lipid degradation process can all lead to dyslipidemia. High triglycerides are mainly related to genetics, bad living and eating habits, and primary diseases of the body.
Cause of symptoms
1. Genetics
Genetic abnormalities are one of the causes of elevated triglycerides, which mainly manifests as familial hypertriglyceridemia. Even if factors such as diet are well controlled for such patients, triglycerides in the blood will still be elevated.
2. Unreasonable living and eating habits
Excessive intake of sugar or meat can cause triglyceride levels to rise. In addition to dietary factors, bad lifestyle habits can also lead to elevated triglycerides, such as lack of exercise, frequent smoking and drinking, and long-term mental stress or anxiety.
3. Primary disease of the body
Patients with diabetes often have elevated triglycerides. In addition, patients with severe obesity and those with liver or kidney disease are also prone to elevated triglycerides.
Common diseases
Hypertriglyceridemia, cerebral thrombosis, arteriosclerosis, myocardial infarction, coronary heart disease, hypertension, stroke, diabetes, etc.
Medical treatment
Outpatient Indications
1. Physical examination revealed that triglycerides in the blood were too high;
2. Obesity or overweight;
3. Accompanied by high blood pressure, blurred vision, dizziness, and headache;
4. Accompanied by repeated chest tightness, palpitations, shortness of breath, etc.;
5. Other severe, persistent or progressive symptoms occur.
All of the above require prompt medical consultation.
Department
Patients with dyslipidemia can undergo relevant examinations and treatments in departments such as endocrinology and cardiovascular medicine.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. The doctor will draw blood for testing and recommends fasting.
3. If you have had medical treatment recently, please bring relevant medical records, examination reports, test results, etc.
4. If you have taken some medicine to relieve symptoms recently, you can carry the medicine box.
5. Family members can be arranged to accompany the patient to seek medical treatment.
6. Patients can prepare a list of questions they want to ask in advance.
Questions your doctor may ask you
1. When did you find out that you had abnormal blood lipids? How did you find out?
2. Do you monitor your blood lipids regularly? Under what circumstances do blood lipids usually increase? Under what circumstances do they decrease?
3. Do you have symptoms such as blurred vision or decreased vision?
4. Do you have symptoms such as abdominal pain, nausea and vomiting, dizziness, headache, and lack of mobility?
5. Do you have symptoms such as chest tightness, palpitations, and shortness of breath?
6. Do you have diabetes, hypertension, coronary heart disease or other diseases?
7. Do any family members have dyslipidemia?
8. What are your daily living habits like? Do you smoke or drink excessively? How long have you been smoking/drinking? How much do you smoke/drink each time? What are your eating habits like?
9. How have your sleep, diet, and urination been since you became unwell?
Questions patients can ask their doctors
1. What is the most likely cause of my dyslipidemia?
2. Are there any other possible reasons?
3. What tests do I need to do?
4. Do I need to be hospitalized?
5. What methods will be used to treat my disease? Can it be cured?
6. What are the risks of these treatments? Will they cause other adverse effects on my body?
7. If medication is possible, what are the usage, dosage, and precautions?
8. I have other physical discomforts. Will it affect my treatment this time?
9. What aspects of my daily life do I need to strengthen? What should I pay attention to?
10. Is there any good way to prevent it?
11. Do I need a follow-up examination? How often? What items are usually reviewed?
examine
Estimated inspection
The doctor will first perform a physical examination on the patient to gain a preliminary understanding of his or her general physical condition. The doctor will then recommend a blood lipid test to determine the levels of various blood lipids in plasma or serum to aid in diagnosis.
Physical examinationIt is mainly through visual examination and other examinations to check whether the patient has symptoms such as xanthomas.
Laboratory tests
It mainly involves blood biochemistry tests. The patient should be on an empty stomach (fast for 12 to 14 hours) before the test, and avoid high-fat foods and alcohol as the last meal.
The specific reference values are as follows:
1. Total cholesterol: appropriate level <5.20mmol/L; marginal level 5.20~6.20mmol/L; elevated level >6.20mmol/L.
2. Triglycerides: Suitable level: 0.56~1.70mmol/L; marginal level: 1.70~2.30mmol/L; elevated level: >2.30mmol/L.
3. Low-density lipoprotein: appropriate level ≤ 3.40mmol/L; marginal level 3.40~4.10mmol/L; elevated >4.10mmol/L.
4. High-density lipoprotein: reference value 1.03~2.07mmol/L; appropriate level >1.04mmol/L; reduction ≤1.0mmol/L.
diagnosis
Diagnostic principlesDoctors can generally make an accurate diagnosis based on the patient’s laboratory test results. If the patient has xanthomas, they should be alert to hypercholesterolemia; if they suddenly feel pain in the precordial area, most of the time it is paroxysmal colic or squeezing pain, they should be alert to coronary heart disease.
Differential Diagnosis
1. Hypertriglyceridemia
Hypertriglyceridemia is a type of hyperlipidemia, which means that the triglyceride level in the plasma exceeds the normal range. Usually, this disease has no obvious clinical manifestations. Some patients with severe conditions may have small yellow particles (xanthomas) around the eyes, or even be overweight or obese. Generally, it can be diagnosed through blood lipid testing.
2. Coronary heart disease
Coronary heart disease is also known as coronary atherosclerotic heart disease. The main clinical symptom is sudden pain in the precordial area, which is usually paroxysmal angina or squeezing pain. It can usually be diagnosed through electrocardiogram, echocardiogram, blood routine test, biochemical test, coronary artery CT and coronary angiography. Among them, coronary angiography is the gold standard for detecting coronary heart disease.
3. Diabetes
Diabetes is a group of metabolic diseases caused by multiple factors and characterized by chronic hyperglycemia. It is caused by defects in insulin secretion and/or action. Clinical symptoms include polyuria, polydipsia, polyphagia, weight loss, skin itching, vulvar itching, etc. It is generally diagnosed based on the patient’s clinical manifestations and urine sugar determination, blood sugar determination, glucose tolerance test and other laboratory tests.
treat
Expected treatment
The key to treatment is to regulate and stabilize blood lipid levels. For patients with secondary diseases, the primary disease needs to be actively treated. The doctor will choose the treatment drugs according to the actual situation of the patient.
Treatment
1. Improve your lifestyle
(1) Reasonable diet: People with high triglycerides need to control their calorie intake as much as possible, eat less fried foods or meat, and try to eat more light foods such as rice porridge, or eat more fresh fruits and vegetables. They also need to quit smoking and drinking.
(2) Strengthen exercise: Lack of exercise is also one of the reasons for increased triglycerides, so people with high triglycerides should try to strengthen exercise, such as jogging, playing basketball, playing badminton, etc.
2. Drug treatment
Commonly used drugs include fibrates, niacin drugs and statins, but it should be noted that fibrates and statins cannot be used at the same time.
(1) Fibrate drugs: mainly include fenofibrate, bezafibrate, etc. This type of drug can significantly reduce the concentration of triglycerides in plasma.
(2) Nicotinic acid drugs: mainly niacin, which can lower triglycerides and low-density lipoprotein in plasma.
(3) Statins: These drugs can also reduce triglycerides to a certain extent, such as simvastatin, atorvastatin, rosuvastatin, etc. The above drugs are contraindicated for people who are allergic to statins and women who are pregnant or breastfeeding.
Related drugsFenofibrate, bezafibrate, niacin, simvastatin, atorvastatin, rosuvastatin
daily
Nursing principles
1. Eat a healthy diet
Many people’s high triglycerides are mainly caused by unhealthy diet, so patients should pay attention to controlling their diet in daily life and try to eat less meat and fried food. At the same time, you can eat more fresh fruits and vegetables, which is conducive to the regulation of blood lipids.
2. Strict medication
For patients who need to take medication for treatment, they must strictly follow the doctor’s instructions and pay attention to adverse reactions of the drugs, such as nausea, vomiting, dizziness, etc. If any adverse reactions occur, inform the doctor in time.
3. Exercise more
For patients with high triglycerides, they must strengthen exercise in daily life, such as jogging, playing basketball, playing badminton and cycling. Proper exercise is not only beneficial to reduce the triglyceride content in the blood, but also can exercise the patient’s cardiopulmonary function.
4. Develop a good lifestyle
People with high triglycerides need to improve their lifestyle, try not to stay up late, quit smoking and drinking, and maintain a happy spirit.
5. Regular review
Patients need to have regular checkups to understand the level of triglycerides in their blood and bring relevant medical records and information when they do.
prevention
Precautions
1. Control your body weight and maintain an appropriate body mass index (BMI 18.5-23.9 kg/m 2 ).
2. Eat a reasonable diet, control total calories, and reduce fat, especially the intake of cholesterol and saturated fatty acids. Eat less fatty meat, squid, egg yolk, fish roe, butter, cocoa butter, liver, brain, kidney and other animal offal; appropriately increase protein and low-animal fat foods, such as fish, chicken, egg whites and soy products, and increase the proportion of carbohydrates in the diet.
3. Exercise appropriately and start physical activities gradually. Do not force yourself to do strenuous activities.
4. Live a regular life, maintain an optimistic and happy mood, combine work and rest, and ensure adequate sleep.
5. Quit smoking and limit alcohol consumption.
6. Actively control risk factors such as blood pressure, blood sugar, etc.