sHTG overview Severe hypertriglyceridemia (sHTG) and the risk of acute pancreatitis (AP)

sHTG is defined as fasting triglyceride levels ≥500 mg/dL. Elevated plasma triglycerides are the result of an excess of triglyceride-rich lipoproteins, most commonly very low-density lipoproteins (VLDLs), chylomicrons, or chylomicron remnants.4

The risk of acute pancreatitis (AP) increases when triglyceride levels exceed 880 mg/dL due to the substantial increase in chylomicrons.5,6

Risk of AP in adult patients with sHTG:

  • Fasting triglyceride levels ≥880 mg/dL in patients with familial chylomicronemia syndrome (FCS) result in up to 90% lifetime AP risk with at least 1 recurrence5,7
  • Every subsequent AP event increases the risk of yet another8
  • A patient's initial AP event increases the risk of another up to 24%8
Triglycerides and Chylomicrons Diagram
Guidelines Icon

Expert guidelines highlight the urgency in lowering triglyceride levels that are ≥500 mg/dL to reduce associated risks6,9-11

Primary and secondary causes of sHTG5,6,12

sHTG primary causes5

Familial chylomicronemia syndrome (FCS)

  • The most severe form of sHTG with fasting triglyceride levels persistently ≥880 mg/dL5,13
  • Also known as Fredrickson type I hyperlipoproteinemia or lipoprotein lipase deficiency7
  • Caused by loss-of-function pathogenic variants in the lipoprotein lipase (LPL) gene and in other genes required for LPL activity14

Multifactorial chylomicronemia syndrome (MCS)

  • Formerly known as Fredrickson type V hyperlipoproteinemia15

sHTG secondary causes5,6,12

  • Clinical conditions such as diabetes, obesity, HIV, and pregnancy
  • Certain medications such as antidepressants, oral contraceptives, and antiretrovirals
  • High alcohol intake and poor diet