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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Spectrum and management of hypertriglyceridemia among children in clinical practice.
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Spectrum and management of hypertriglyceridemia among children in clinical practice.

机译：儿童实践中高甘油三酯血症的频谱和管理。

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OBJECTIVES: The prevalence and identification of hypertriglyceridemia in youths will likely will increase in the future as a consequence of childhood obesity and increased screening for dyslipidemias. We sought to review our clinical experience with hypertriglyceridemia, evaluate factors associated with increased triglyceride levels, and review treatment options to provide guidance for management. METHODS: Clinical review of data for all patients who had > or =1 elevated triglyceride level (>4 mmol/L [>350 mg/dL]) while being monitored in a specialized lipid disorders clinic was performed. RESULTS: The study population consisted of 76 patients with 761 clinic visits. Hypertriglyceridemia was secondary to lifestyle factors for 13 patients. The rest had primary hypertriglyceridemia, with 32 patients having familial combined hypertriglyceridemia and hypercholesterolemia (type II), 25 patients having primary hypertriglyceridemia (type IV), 4 patients having familial lipase deficiency (type I), and 2 patients having hyperlipoproteinemia E2/E2 phenotype (type III). Triglyceride levels were highest in type I and III hypertriglyceridemia (>10 mmol/L [>900 mg/dL]), followed by type IV and adiposity-related hypertriglyceridemia (>4 mmol/L [>350 mg/dL]) and finally type II familial combined hypertriglyceridemia and hypercholesterolemia (>2 mmol/L [>180 mg/dL]). A total of 34 patients received 37 trials of drug therapy as part of triglyceride level management (bile acid-binding resins, n = 12; fibrates, n = 19; statins, n = 6). Triglyceride levels were found to decrease over time with the use of fibrates, to increase with the use of bile acid-binding resins, and not to change with the use of statins. CONCLUSIONS: Lifestyle modifications remain the primary therapeutic avenue for the management of pediatric hypertriglyceridemia. We propose an algorithm for the management of this heterogeneous population to guide clinicians in their treatment decisions.
机译：目的：由于儿童肥胖和血脂异常筛查的增加，青少年高甘油三酯血症的患病率和识别率将来可能会增加。我们试图回顾我们在高甘油三酯血症方面的临床经验，评估与甘油三酸酯水平升高相关的因素，并回顾治疗方案以为治疗提供指导。方法：对所有在专门的脂质疾病诊所接受监测的甘油三酸酯水平>或= 1（> 4 mmol / L [> 350 mg / dL]）的患者进行临床回顾。结果：研究人群包括76例患者，共进行761次临床就诊。高甘油三酸酯血症是继发于生活方式因素的13例患者。其余患者患有原发性高甘油三酯血症，其中32例合并家族性高甘油三酸酯血症和高胆固醇血症（II型），25例患有原发性高甘油三酯血症（IV型），4例家族脂肪酶缺乏症（I型），2例具有高脂蛋白血症E2 / E2表型（III型）。甘油三酯水平在I型和III型高甘油三酯血症中最高（> 10 mmol / L [> 900 mg / dL]），其次是IV型和与肥胖有关的高甘油三酸酯血症（> 4 mmol / L [> 350 mg / dL]），最后II型家族性合并高甘油三酯血症和高胆固醇血症（> 2 mmol / L [> 180 mg / dL]）。共有34位患者接受了37项甘油三酯水平管理的药物治疗试验（胆汁酸结合树脂，n = 12;贝特类药物，n = 19;他汀类药物，n = 6）。发现甘油三酸酯水平随使用贝特类药物随时间降低，随胆汁酸结合树脂的使用而增加，而随他汀类药物的使用而没有变化。结论：改变生活方式仍然是治疗小儿高甘油三酯血症的主要治疗途径。我们提出了一种管理这种异质性种群的算法，以指导临床医生的治疗决策。

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