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<p>In this article, hypertriglyceridemia and elevated lipoprotein(a), two common problems in lipidology, will be discussed from a&#xa0;practical clinical perspective. Hypertriglyceridemia is clinically relevant because of its association with atherosclerosis and acute pancreatitis. In order to achieve better comparability, the lipid status in hypertriglyceridemia should be determined under fasting conditions. It is important to exclude secondary factors (derailed diabetes mellitus, alcohol, obesity, etc.) as additional factors in a&#xa0;mostly existing genetic predisposition. Therapeutically, the focus is on lifestyle measures and achieving the low-density lipoprotein (LDL) cholesterol target. If these measures are not sufficient to achieve triglyceride levels &lt; 400 mg/dl (4.6 mmol/l), a&#xa0;therapy trial with fibrates or high-dose omega‑3 fatty acids can be carried out.</p><p>Lipoprotein(a) is a&#xa0;risk factor for atherosclerosis and aortic valve calcification. The plasma level is largely genetically determined and can barely be influenced by lifestyle measures and medication. Elevated lipoprotein(a) levels must be interpreted in the context of other risk factors and should be a&#xa0;reason to optimize these (especially LDL cholesterol). New lipoprotein(a) lowering drugs are being developed.</p>

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Fettstoffwechselstörungen: Hypertriglyzeridämie und Lipoprotein(a)-Erhöhung im Fokus

  • 期刊论文

  • 发表日期：

    2025年4月4日

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  • Klaus G. Parhofer

摘要

In this article, hypertriglyceridemia and elevated lipoprotein(a), two common problems in lipidology, will be discussed from a practical clinical perspective. Hypertriglyceridemia is clinically relevant because of its association with atherosclerosis and acute pancreatitis. In order to achieve better comparability, the lipid status in hypertriglyceridemia should be determined under fasting conditions. It is important to exclude secondary factors (derailed diabetes mellitus, alcohol, obesity, etc.) as additional factors in a mostly existing genetic predisposition. Therapeutically, the focus is on lifestyle measures and achieving the low-density lipoprotein (LDL) cholesterol target. If these measures are not sufficient to achieve triglyceride levels < 400 mg/dl (4.6 mmol/l), a therapy trial with fibrates or high-dose omega‑3 fatty acids can be carried out.

Lipoprotein(a) is a risk factor for atherosclerosis and aortic valve calcification. The plasma level is largely genetically determined and can barely be influenced by lifestyle measures and medication. Elevated lipoprotein(a) levels must be interpreted in the context of other risk factors and should be a reason to optimize these (especially LDL cholesterol). New lipoprotein(a) lowering drugs are being developed.