New guidelines: Screen adults for hypertriglyceridemia every 5 years

September 20, 2012

An Endocrine Society task force has established new clinical-practice guidelines that recommend screening adults for high triglyceride levels. Find out the reason behind the new recommendations and how often the screening should be administered.

An Endocrine Society task force has established new clinical-practice guidelines that recommend screening adults for high triglyceride levels once every 5 years because of the potential risk of cardiovascular disease and pancreatitis associated with hypertriglyceridemia.

The new recommendations are published in the September 2012 issue of the Journal of Clinical Endocrinology & Metabolism.

Task-force chair Lars Berglund, MD, PhD, with the University of California, Davis, and colleagues, received approval to recommend the following:

Diagnosis of hypertriglyceridemia should be based on fasting levels

Mild and moderate hypertriglyceridemia (triglycerides of 150–999 mg/dL) should be diagnosed to aid in the evaluation of cardiovascular risk

Severe and very severe hypertriglyceridemia (triglycerides of > 1000 mg/dL) should be considered as a risk for pancreatitis

Patients with hypertriglyceridemia should be evaluated for secondary causes of hyperlipidemia

Patients with primary hypertriglyceridemia should be evaluated for a family history of dyslipidemia and cardiovascular disease

The task force also recommends that the treatment goal in patients with moderate hypertriglyceridemia be a non-HDL cholesterol level in agreement with National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) guidelines. Lifestyle therapy should be the initial treatment, followed by a combination of diet changes and drug therapy. And, in patients with severe or very severe hypertriglyceridemia, a fibrate should be used as a first-line agent.

"Severe and very severe hypertriglyceridemia increase the risk for pancreatitis, while mild or moderate hypertriglyceridemia may be a risk factor for cardiovascular disease," the authors wrote. "Therefore, similar to the NCEP ATP III guidelines committee's recommendations, we recommend screening adults for hypertriglyceridemia as part of a fasting lipid panel at least every five years."

The task force consisted of Berglund, who was selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), five additional field experts, and a methodologist. The guidelines were reviewed and approved sequentially by the CGS, Clinical Affairs Core Committee, members responding to a web posting, and The Endocrine Society Council.