Endocrine Abstracts

Introduction: Severe hypertriglyceridemia is a condition when triglycerides levels are over 500 mg/dl. It is serious risk-factor for cardiovascular disorders and acute pancreatitis. Especially in combination with glucose intolerance, abdominal obesity, and fatty liver.

Case: We present case of 27 y.o male with Severe Hypertriglyceridemia and Metabolic syndrome. 27 y.o male presented to clinic with several years of untreated Severe Hypertriglyceridemia history. He refused to take fenofibrate for years, but his triglycerides levels even on fenofibrate were never below 500 mg/dl.

Family history: Mom and Dad with Slightly elevated triglycerides and little brother with severely elevated triglycerides. Although Genetic testing was not done, we suppose that it is Familial Hypertriglyceridemia. He gained 20 kg past year. Height – 186 cm, Weight – 100 kg, BMI – 28.9 kg/m2. Waist circumference – 115 cm.

Laboratory Data: Triglycerides – >2625 mg/dl,

T-Cholesterol – 249 mmol/l,

HDL – 13 mg/dl,

LDL – 30.16 mmol/l,

VLDL – No results,

AI – 17.42.

HBA1c – 5.4%,

Glucose – 5.38 mmol/l,

Insulin Resistance index – 2.4,

Basal Insulin – 127.9 pmol/l.

TSH – in normal range.

Prescription: 1. Lifestyle intervention (Healthy Eating Plan)

2. Fenofibrate – 145 mg daily

3. Rosuvastatin – 20 mg daily

4. Fish Oil – 4 g. daily

5. Metformin – 1000 mg daily

Follow-up after 2 months (January, 2023): 1. Weight loss – 10 kg. Height 186 cm, weight – 90 kg, BMI – 26.0 kg/m². Waist Circumference – 107 cm.

T-Cholesterol – 157.77 mg/dl

HDL – 27.456 mg/dl,

LDL – 69.6 mg/dl,

Triglycerides – 313.55 mg/dl,

VLDL – 62.64 mg/dl

AI – 4.75.

HBA1c – 5.4%,

Glucose – 4.95 mmol/l,

Insulin Resistance index – 2.19,

Basal Insulin – 119.6 pmol/l.

Patient continues healthy lifestyle modifications in his everyday living and Pharmacologic therapy without changes. Follow-up check-up in 3 months.

Conclusion: It is very important to increase awareness about hypertriglyceridemia and importance of dietary changes and pharmacological therapy especially in patients with familial hypertriglyceridemia and metabolic syndrome.