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中度高血脂 150-885 mg/dL嚴重高血脂 ≥885 mg/dL
SUMMARY AND RECOMMENDATIONS
●This topic refers to the range of fasting triglyceride (TG) levels from 150 to 885 mg/dL (1.7 to 10 mmol/L) as moderate hypertriglyceridemia and ≥885 mg/dL as "severe" hypertriglyceridemia. (See 'Definition' above.)
●Elevated TG levels are independently associated with atherosclerotic cardiovascular disease (ASCVD) risk, particularly coronary heart disease risk. However, causality has not been established. (See 'Association with ASCVD' above.)
三酸甘油脂過高, 應先嘗試非藥物治療, 改善生活型態, 減重, 有氧運動, 避免醣類, 注意是否有其他會造成TG上升的藥物. 如果有糖尿病, 應嚴格控制血糖, 作為第一線治療.
其他心血管動脈粥狀硬化的危險因子也要重視, 例如高血壓, 抽菸.
●All patients with hypertriglyceridemia should participate in nonpharmacologic lifestyle interventions such as weight loss in obese patients, aerobic exercise, and avoidance of concentrated sugars and medications that raise serum TG levels. Excellent glycemic control in patients with diabetes should be first-line therapy. Other risk factors for ASCVD, such as hypertension and smoking, should also be addressed. (See 'Management' above.)
如果TG過高同時合併LDL過高, 應考慮使用 statin 治療
●All patients with hypertriglyceridemia should have an assessment of their low-density lipoprotein cholesterol level. If the patient is not at goal, statin therapy should be considered. (See 'Triglyceride levels between 150 and 885 mg/dL' above.)
若經過非藥物治療, TG仍然超過 885, 建議給予 fibrate 治療
●For patients with TG levels persistently >885 mg/dL (10 mmol/L) after nonpharmacologic interventions, we suggest starting drug therapy to lower the risk of pancreatitis (Grade 2C). We start with a fibrate. (See 'Triglyceride levels above 885 mg/dL' above.).
●All patients with hypertriglyceridemia should participate in nonpharmacologic lifestyle interventions such as weight loss in obese patients, aerobic exercise, and avoidance of concentrated sugars and medications that raise serum TG levels. Excellent glycemic control in patients with diabetes should be first-line therapy. Other risk factors for ASCVD, such as hypertension and smoking, should also be addressed. (See 'Management' above.)
如果TG過高同時合併LDL過高, 應考慮使用 statin 治療
●All patients with hypertriglyceridemia should have an assessment of their low-density lipoprotein cholesterol level. If the patient is not at goal, statin therapy should be considered. (See 'Triglyceride levels between 150 and 885 mg/dL' above.)
若經過非藥物治療, TG仍然超過 885, 建議給予 fibrate 治療
●For patients with TG levels persistently >885 mg/dL (10 mmol/L) after nonpharmacologic interventions, we suggest starting drug therapy to lower the risk of pancreatitis (Grade 2C). We start with a fibrate. (See 'Triglyceride levels above 885 mg/dL' above.).
以經服用statin的患者, 如果TG介於 150-885 之間, 應考慮給予第二種降血脂藥物. 通常選擇每天吃 四公克 魚油 Vascepa 0.5g capsules icosapent ethyl
●For patients with TG levels between 150 mg/dL (1.7 mmol/L) and 885 mg/dL (10 mmol/L) taking statin therapy, we suggest adding a second lipid-lowering drug, for cardiovascular disease events (Grade 2C). (See 'Triglyceride levels between 150 and 885 mg/dL' above.)
We usually start with icosapent ethyl (fish oil) 4 g daily.
●For patients with hypertriglyceridemia not clearly associated with a secondary cause, we screen family members with a fasting TG level. (See 'Screening' above.)
