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- *Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
- †Department of Pediatrics, Harlem Hospital Center, New York, NY
- ‡Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Children’s of Alabama, University of Alabama at Birmingham, Birmingham, AL
AUTHOR DISCLOSURE
Drs Valaiyapathi and Sunil have disclosed no financial relationships relevant to this article. Dr Ashraf has disclosed that she has a research grant from Merck, she serves as mentor to the principal investigator on a grant from Thrasher Research Fund, and her spouse is on the speakers’ bureaus of Pfizer, Bristol-Myers Squibb, and Celgene. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.
Abstract
Hypertriglyceridemia is increasingly identified in children and adolescents, owing to improved screening and higher prevalence of childhood obesity. Hypertriglyceridemia can result from either increased triglyceride (TG) production or reduced TG clearance. The etiologic origin can be primary (genetic) or secondary, but it is often multifactorial. Management is challenging because of the interplay of genetic and secondary causes and lack of evidence-based guidelines. Lifestyle changes and dietary interventions are most important, especially in hypertriglyceridemia associated with obesity. Dietary restriction of fat remains the mainstay of management in primary hypertriglyceridemia. When fasting TG concentration is increased above 500 mg/dL (5.65 mmol/L), fibrates may be used to prevent pancreatitis. Omega-3 fatty acids are often used as an adjunctive therapy. When the fasting TG concentration is less than 500 mg/dL (5.65 mmol/L) and if the non–high-density lipoprotein cholesterol level is above 145 mg/dL (3.76 mmol/L), statin treatment can be considered.
- © American Academy of Pediatrics, 2017. All rights reserved.
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