35 y/o woman with Hypertriglyceridemia Pancreatitis
Dr. Ira Tabas | Morning Report | 05/08/2017
Pregnant woman have increased Triglycerides:
Estrogen inhibits Lipoprotein Lipase (water-soluble enzyme that hydrolyzes Triglycerides)
Posted 05/08/17 09:43:22 AM by Adam Faye
Fibrates and Omega - decrease lipoproteins synthesized by the liver
2 different types of fibrates: Gemfibrozil interacts with statins so generally use fenofibrate instead
Fibrates + statins can lower TGs. Statins can only increase TG clearance if particles are reduced in size - thus need to combine with fibrates.
Posted 05/08/17 09:48:18 AM by Adam Faye
Omega (Fish oil) can raise LDL - except for Vascepa
Posted 05/08/17 09:51:14 AM by Adam Faye
HyperTG Pancreatitis: Rx: Insulin and NPO 90% of the time will resolve TG level and pancreatitis
Ignore total cholesterol level until TG levels normalize
Some data about heparin; it looks like Lipoprotein Lipase so can take the place of LPL on the endothelium and free up LPL to work by hydrolyzing TGs. Only issue is that if liver does not synthesize more by the time LPL is utilized - can have a rebound effect so tend not to use heparin.
Apheresis only if management above cannot improve TG/symptoms. Generally do not need to use apheresis