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Hypertriglyceridemia: HELP
Articles from Minnesota
Based on 31 articles published since 2010
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These are the 31 published articles about Hypertriglyceridemia that originated from Minnesota during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Hemolyzed blood as a clue to the diagnosis of abdominal pain. 2016

Tariq, Raseen / Khanna, Sahil. ·Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. khanna.sahil@mayo.edu. ·Intern Emerg Med · Pubmed #26345537.

ABSTRACT: -- No abstract --

2 Review Toxic-metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management, and Future Research. 2016

Husain, Sohail Z / Morinville, Veronique / Pohl, John / Abu-El-Haija, Maisam / Bellin, Melena D / Freedman, Steve / Hegyi, Peter / Heyman, Melvin B / Himes, Ryan / Ooi, Chee Y / Schwarzenberg, Sarah J / Usatin, Danielle / Uc, Aliye. ·*Children's Hospital of Pittsburgh, Pittsburgh, PA †Montreal Children's Hospital, McGill University, Montreal, QC, Canada ‡University of Utah, Salt Lake City §Cincinnati Children's Hospital Medical Center, Cincinnati, OH ||University of Minnesota Masonic Children's Hospital, Minneapolis ¶Harvard Medical School, Boston, MA #First Department of Medicine, University of Szeged and HAS-SZTE Monument Gastroenterology Multidisciplinary Research Group, Szeged, Hungary **University of California at San Francisco, San Francisco ††Baylor College of Medicine, Houston, TX ‡‡Discipline of Paediatrics, School of Women's and Children's Health, Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, Australia §§University of Iowa Carver College of Medicine, Iowa City. ·J Pediatr Gastroenterol Nutr · Pubmed #26594832.

ABSTRACT: Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies, and their rationale. We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: hyperlipidemia, hypercalcemia, chronic renal failure, smoking exposure, alcohol, and medications. Areas of additional research were identified. Hypertriglyceridemia of 1000 mg/dL or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end-stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and bystander status may be implicated. Other pancreatitis risk factors must be sought in all cases. The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children.

3 Review Fat depots, free fatty acids, and dyslipidemia. 2013

Ebbert, Jon O / Jensen, Michael D. ·Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. ebbert.jon@mayo.edu ·Nutrients · Pubmed #23434905.

ABSTRACT: Body fat deposition and excess free fatty acid (FFA) metabolism contribute to dyslipidemia and the adverse health consequences of obesity. Individuals with upper body obesity have impaired functioning of adipocytes, the primary fatty acid storage site. Excess visceral fat is strongly associated with impaired suppression of FFA release in response to insulin, as well as with hypertriglyceridemia and low concentrations of high density lipoprotein (HDL) cholesterol. High FFA concentrations can induce insulin resistance in muscle and liver. Furthermore, failure of hyperinsulinemia to normally suppress FFA is associated with impaired carbohydrate oxidation and muscle glucose storage, reduced hepatic insulin clearance and elevated triglycerides. Understanding the impact of body fat distribution on FFA metabolism and dyslipidemia is critical for determining the link between overweight and obesity and cardiovascular disease risk. In the current review, we will explore the relationship between adipose tissue, body fat depots, and FFA metabolism.

4 Clinical Trial Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals. 2015

Raatz, Susan K / Johnson, LuAnn K / Picklo, Matthew J. ·USDA Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND; and Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN susan.raatz@ars.usda.gov. · USDA Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND; and. ·J Nutr · Pubmed #26338891.

ABSTRACT: BACKGROUND: Public health recommendations call for a reduction in added sugars; however, controversy exists over whether all nutritive sweeteners produce similar metabolic effects. OBJECTIVE: The objective was to compare the effects of the chronic consumption of 3 nutritive sweeteners [honey, sucrose, and high-fructose corn syrup containing 55% fructose (HFCS55)] on circulating glucose, insulin, lipids, and inflammatory markers; body weight; and blood pressure in individuals with normal glucose tolerance (GT) and those with impaired glucose tolerance (IGT). METHODS: In a crossover design, participants consumed daily, in random order, 50 g carbohydrate from assigned sweeteners for 2 wk with a 2- to 4-wk washout period between treatments. Participants included 28 GT and 27 IGT volunteers with a mean age of 38.9 ± 3.6 y and 52.1 ± 2.7 y, respectively, and a body mass index (in kg/m(2)) of 26 ± 0.8 and 31.5 ± 1.0, respectively. Body weight, blood pressure (BP), serum inflammatory markers, lipids, fasting glucose and insulin, and oral-glucose-tolerance tests (OGTTs) were completed pre- and post-treatment. The OGTT incremental areas under the curve (iAUCs) for glucose and insulin were determined and homeostasis model assessment of insulin resistance (HOMA-IR) scores were calculated. RESULTS: Body weight and serum glucose, insulin, inflammatory markers, and total and LDL-cholesterol concentrations were significantly higher in the IGT group than in the GT group at baseline. Glucose, insulin, HOMA-IR, and the OGTT iAUC for glucose or insulin did not differ by treatment, but all responses were significantly higher in the IGT group compared with the GT group. Body weight was unchanged by treatment. Systolic BP was unchanged, whereas diastolic BP was significantly lower in response to sugar intake across all treatments. An increase in high-sensitivity C-reactive protein (hsCRP) was observed in the IGT group in response to all sugars. No treatment effect was observed for interleukin 6. HDL cholesterol did not differ as a result of status or treatment. Triglyceride (TG) concentrations increased significantly from pre- to post-treatment in response to all sugars tested. CONCLUSIONS: Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG concentrations in both GT and IGT individuals and elevated glycemic and inflammatory responses in the latter. This trial was registered at clinicaltrials.gov as NCT01371266.

5 Article Elevated Triglycerides (≥150 mg/dL) and High Triglycerides (200-499 mg/dL) Are Significant Predictors of New Heart Failure Diagnosis: A Real-World Analysis of High-Risk Statin-Treated Patients. 2019

Toth, Peter P / Philip, Sephy / Hull, Michael / Granowitz, Craig. ·CGH Medical Center, Sterling, IL, USA. · Johns Hopkins University School of Medicine, Baltimore, MD, USA. · Amarin Pharma Inc, Bedminster, NJ, USA. · Optum, Eden Prairie, MN, USA. ·Vasc Health Risk Manag · Pubmed #31824165.

ABSTRACT: Purpose: Real-world data may provide insight into relationships between high triglycerides (TG), a modifiable cardiovascular (CV) risk factor, and increased heart failure (HF) risk. Patients and methods: This retrospective administrative claims analysis included statin-treated patients aged ≥45 years with diabetes and/or atherosclerotic CV disease enrolled in 2010 and followed for ≥6 months to March 2016. Patients with TG ≥150 mg/dL and a comparator cohort with TG <150 mg/dL and high-density lipoprotein cholesterol >40 mg/dL were included. A sub-analysis was conducted in patients with TG 200-499 mg/dL. Hazard ratios (HR) were calculated from multivariate analyses controlled for patient characteristics and comorbidities using Cox proportional hazard modeling. New diagnosis of HF required diagnosis in the follow-up period without prior evidence of HF. Results: Multivariate analyses revealed a 19% higher rate of new HF diagnosis in the TG ≥150 mg/dL cohort (HR=1.192; 95% confidence interval [CI]=1.134-1.252; Conclusion: In a real-world analysis of statin-treated patients with high CV risk, elevated and high TG were significant predictors of new HF diagnosis.

6 Article The economic burden of hypertriglyceridemia among US adults with diabetes or atherosclerotic cardiovascular disease on statin therapy. 2019

Case, Brian C / Bress, Adam P / Kolm, Paul / Philip, Sephy / Herrick, Jennifer S / Granowitz, Craig B / Toth, Peter P / Fan, Wenjun / Wong, Nathan D / Hull, Michael / Weintraub, William S. ·MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, Washington, DC. · Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT. · Medical Affairs, Amarin Pharma, Inc, Bedminster, NJ. · Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT. · Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD. · Department of Medicine, School of Medicine University of California, Irvine, CA. · Health Economics and Outcomes Research, Optum Research Database, Eden Prairie, MN. · MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, Washington, DC. Electronic address: william.s.weintraub@medstar.net. ·J Clin Lipidol · Pubmed #31427271.

ABSTRACT: BACKGROUND: Hypertriglyceridemia (HTG) is associated with increased cardiovascular disease (CVD) risk. However, the cost burden of HTG-related CVD in high-risk US adults on statins has not been well characterized. OBJECTIVE: We estimated the HTG-related health care cost burden among US adults with CVD or diabetes taking statin therapy. METHODS: We estimated population sizes and annual health care costs among US adults aged ≥45 years with diabetes or CVD taking statin therapy with normal triglycerides (TGs) defined as TG < 150 mg/dL compared with those with HTG defined as TG ≥ 150 mg/dL. Population sizes were estimated from the 2007-2014 National Health and Nutrition Examination Surveys. Adjusted mean total annual health care costs in 2015 US dollars were estimated using the Optum Research Database. The annual total health care cost burden was estimated by multiplying the population size by the mean annual total incremental health care costs overall and within subgroups. RESULTS: There were 6.2 (95% confidence interval [CI], 5.4 - 7.1) million and 12.0 (95% CI, 11.1 - 12.9) million US adults aged ≥45 years with diabetes and/or CVD on statin therapy with TG ≥ 150 mg/dL and TG < 150 mg/dL, respectively. The mean adjusted incremental total one-year health care costs in adults with TG ≥ 150 mg/dL compared with those with TG < 150 mg/dL was $1730 (95% CI, $1160 - $2320). This leads to a projected annual incremental cost burden associated with HTG in patients with diabetes or CVD on statins of $10.7 billion (95% CI, $6.8 B - $14.6 B). CONCLUSION: In US adults on statins and at high risk for CVD, the health care costs associated with HTG are substantial.

7 Article Association of Elevated Triglycerides With Increased Cardiovascular Risk and Direct Costs in Statin-Treated Patients. 2019

Toth, Peter P / Philip, Sephy / Hull, Michael / Granowitz, Craig. ·Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Preventive Cardiology, CGH Medical Center, Sterling, IL. Electronic address: Peter.Toth@cghmc.com. · Department of Medical Affairs, Amarin Pharma, Inc, Bedminster, NJ. · Department of Health Economics and Outcomes Research, Optum, Inc, Eden Prairie, MN. ·Mayo Clin Proc · Pubmed #31405751.

ABSTRACT: OBJECTIVE: To retrospectively investigate the real-world impact of elevated triglyceride (TG) levels on cardiovascular (CV) outcomes, medical resource utilization, and medical costs using observational administrative claims data from the Optum Research Database. METHODS: Patients with one or more claims for statin therapy between January 1, 2010, and December 31, 2010, and 6 months or more of baseline data prior to the index date were eligible for inclusion in the study. Patients aged 45 years or older with diabetes and/or atherosclerotic CV disease were included and analyzed in an elevated TG cohort (≥150 mg/dL) vs a comparator cohort with TG levels less than 150 mg/dL and high-density lipoprotein cholesterol (HDL-C) levels greater than 40 mg/dL. RESULTS: In the elevated TG vs propensity-matched comparator cohorts (both N=23,181 patients), the mean age was 62.2 vs 62.6 years, mean follow-up was 41.4 vs 42.5 months, 49.7% (11,518) vs 49.5% (11,467) were female, 83.7% (19,392) vs 84.0% (19,478) had diabetes, and 29.8% (6915) vs 29.3% (6800) had atherosclerotic CV disease. In the elevated TG (N=27,471 patients) vs comparator (N=32,506 patients) cohorts, multivariate analysis revealed significantly greater risk of composite major CV events (hazard ratio [HR], 1.26; 95% CI, 1.19-1.34; P<.001), nonfatal myocardial infarction (HR, 1.32; 95% CI, 1.20-1.45; P<.001), nonfatal stroke (HR, 1.14; 95% CI, 1.04-1.24; P=.004), and need for coronary revascularization (HR, 1.46; 95% CI, 1.33-1.61; P<.001) but not unstable angina (P=.53) or CV death (P=.23). Increased CV risk was maintained with the addition of non-HDL-C to the multivariate model and with high and low HDL-C subgroup analysis. Total direct health care costs (cost ratio, 1.12; 95% CI, 1.08-1.16; P<.001) and inpatient hospital stays (HR, 1.13; 95% CI, 1.10-1.17; P<.001) were significantly higher in the elevated TG cohort vs the comparator cohort. CONCLUSION: Statin-treated patients with TG levels of 150 mg/dL or greater had worse CV and health economic outcomes than those with well-managed TG (<150 mg/dL) and HDL-C (>40 mg/dL) levels.

8 Article 32-Year-Old Man With New Onset Abdominal Pain. 2019

Shabtaie, Samuel A / Codipilly, Don Chamil / Sweetser, Seth. ·Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN. · Resident in Gastroenterology and Hepatology, Mayo Clinic School of Graduate Medical Education, Rochester, MN. · Advisor to residents and Consultant in Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. Electronic address: sweetser.seth@mayo.edu. ·Mayo Clin Proc · Pubmed #31378233.

ABSTRACT: -- No abstract --

9 Article The challenge of detecting genotype-by-methylation interaction: GAW20. 2018

de Andrade, Mariza / Warwick Daw, E / Kraja, Aldi T / Fisher, Virginia / Wang, Lan / Hu, Ke / Li, Jing / Romanescu, Razvan / Veenstra, Jenna / Sun, Rui / Weng, Haoyi / Zhou, Wenda. ·Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. mandrade@mayo.edu. · Division of Statistical Genomics, Department of Genetics, Center for Genome Sciences and Systems Biology, Washington University School of Medicine, 660 Euclid Ave, Saint Louis, MO, 63110, USA. · Department of Biostatistics, Boston University School of Public Health, Boston, 715 Albany St, Boston, MA, 02118, USA. · Department of Electrical Engineering and Computer Science, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA. · Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, 600 University Ave, Toronto, ON, M5G 1X5, Canada. · Department of Biology, Dordt College, 498 4th Ave. NE, Sioux Center, IA, 51250, USA. · Department of Mathematics and Statistics, Dordt College, 498 4th Ave. NE, Sioux Center, IA, 51250, USA. · Division of Biostatistics, Centre for Clinical Research and Biostatistics, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Shatin, N.T, Hong Kong, SAR, China. · CUHK Shenzhen Research Institute, Shenzhen, China. · Department of Statistics, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA. ·BMC Genet · Pubmed #30255819.

ABSTRACT: BACKGROUND: GAW20 working group 5 brought together researchers who contributed 7 papers with the aim of evaluating methods to detect genetic by epigenetic interactions. GAW20 distributed real data from the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study, including single-nucleotide polymorphism (SNP) markers, methylation (cytosine-phosphate-guanine [CpG]) markers, and phenotype information on up to 995 individuals. In addition, a simulated data set based on the real data was provided. RESULTS: The 7 contributed papers analyzed these data sets with a number of different statistical methods, including generalized linear mixed models, mediation analysis, machine learning, W-test, and sparsity-inducing regularized regression. These methods generally appeared to perform well. Several papers confirmed a number of causative SNPs in either the large number of simulation sets or the real data on chromosome 11. Findings were also reported for different SNPs, CpG sites, and SNP-CpG site interaction pairs. CONCLUSIONS: In the simulation (200 replications), power appeared generally good for large interaction effects, but smaller effects will require larger studies or consortium collaboration for realizing a sufficient power.

10 Article An adaptive gene-level association test for pedigree data. 2018

Park, Jun Young / Wu, Chong / Pan, Wei. ·Division of Biostatistics, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA. · Division of Biostatistics, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA. weip@biostat.umn.edu. ·BMC Genet · Pubmed #30255770.

ABSTRACT: BACKGROUND: We propose a gene-level association test that accounts for individual relatedness and population structures in pedigree data in the framework of linear mixed models (LMMs). Our method data-adaptively combines the results across a class of score-based tests, only requiring fitting a single null model (under the null hypothesis) for the whole genome, thereby being computationally efficient. RESULTS: We applied our approach to test for association with the high-density lipoprotein (HDL) ratio of post- and pretreatments in GAW20 data. Using the LMM similar to that used by Aslibekyan et al. (PLos One, 7:48663, 2012), our method identified 2 nearly significant genes (APOA5 and ZNF259) near rs964184, whereas neither the other gene-level tests nor the standard test on each individual single-nucleotide polymorphism (SNP) detected any significant gene in a genome-wide scan. CONCLUSIONS: Gene-level association testing can be a complementary approach to the SNP-level association testing and our method is adaptive and efficient compared to several other existing gene-level association tests.

11 Article Linear yellow papules following a cat scratch. 2018

Lehman, Julia S / Nault, Ashley M / Smith, Steven A / McEvoy, Marian T. ·Department of Dermatology, Mayo Clinic, Rochester, MN, USA. · Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, MN, USA. ·Int J Dermatol · Pubmed #29450887.

ABSTRACT: -- No abstract --

12 Article Association of Psoriasis With Comorbidity Development in Children With Psoriasis. 2018

Tollefson, Megha M / Van Houten, Holly K / Asante, Dennis / Yao, Xiaoxi / Maradit Kremers, Hilal. ·Department of Dermatology, Mayo Clinic, Rochester, Minnesota. · Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota. · Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota. · OptumLabs, Cambridge, Massachusetts. · Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. ·JAMA Dermatol · Pubmed #29322175.

ABSTRACT: Importance: Children with psoriasis are at increased risk for comorbidities. Many children with psoriasis are also overweight or obese; it is unknown whether the increased risk of comorbidities in these children is independent of obesity. Objective: To determine the risk of elevated lipid levels (hyperlipidemia/hypertriglyceridemia), hypertension, metabolic syndrome, polycystic ovarian syndrome, diabetes, nonalcoholic liver disease, and elevated liver enzyme levels in children with and without psoriasis, after accounting for obesity. Design, Setting, and Participants: This was a retrospective cohort study of claims data from Optum Laboratories Data Warehouse (includes 150 million privately insured and Medicare enrollees). A cohort of 29 957 children with psoriasis (affected children) and an age-, sex-, and race-matched comparator cohort of 29 957 children without psoriasis were identified and divided into 4 groups: (1) nonobese, without psoriasis (reference cohort); (2) nonobese, with psoriasis; (3) obese, without psoriasis; and (4) obese, with psoriasis. Main Outcomes and Measures: Risk of developing comorbidities (Cox proportional hazards regression). Results: The overall mean (SD) age of those included in the cohort was 12.0 (4.4) years, and 16 034 (53.5%) were girls. At baseline, more affected children were obese (862 [2.9%] vs 463 [1.5%]; P < .001 for all comparisons). Children with psoriasis were significantly more likely to develop each of the comorbidities than those without psoriasis (P < .01). Obesity was a strong risk factor for development of each comorbidity, even in those without psoriasis (hazard ratios [HRs] ranging from 2.26 to 18.11). The risk of comorbidities was 40% to 75% higher among nonobese children with vs without psoriasis: elevated lipid levels (HR, 1.42; 95% CI, 1.25-1.62), hypertension (HR, 1.64; 95% CI, 1.40-1.93), diabetes (HR, 1.58; 95% CI, 1.27-1.95), metabolic syndrome (HR, 1.62; 95% CI, 1.13-2.33), polycystic ovarian syndrome (HR, 1.49; 95% CI, 1.18-1.88), nonalcoholic liver disease (HR, 1.76; 95% CI, 1.16-2.65), and elevated liver enzyme levels (HR, 1.46; 95% CI, 1.27-1.67). Except for hypertension (P = .03), no significant interaction occurred between psoriasis and obesity on the risk of comorbidities. Conclusions and Relevance: Children with psoriasis are at greater risk of developing obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, nonalcoholic liver disease, and elevated liver function enzyme levels than children without psoriasis. While psoriasis is a small independent risk factor for the development of these comorbidities, obesity is a much stronger contributor to comorbidity development in children with psoriasis.

13 Article Mitochondrial 3-Hydroxy-3-Methylglutaryl-CoA Synthase Deficiency: Unique Presenting Laboratory Values and a Review of Biochemical and Clinical Features. 2018

Conboy, Erin / Vairo, Filippo / Schultz, Matthew / Agre, Katherine / Ridsdale, Ross / Deyle, David / Oglesbee, Devin / Gavrilov, Dimitar / Klee, Eric W / Lanpher, Brendan. ·Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA. · Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA. Lanpher.Brendan@mayo.edu. · Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA. Lanpher.Brendan@mayo.edu. ·JIMD Rep · Pubmed #29030856.

ABSTRACT: We report an 8-month-old infant with decreased consciousness after a febrile episode and reduced oral intake. He was profoundly acidotic but his lactate was normal. Serum triglycerides were markedly elevated and HDL cholesterol was very low. The urine organic acid analysis during the acute episode revealed a complex pattern of relative hypoketotic dicarboxylic aciduria, suggestive of a potential fatty acid oxidation disorder. MRI showed extensive brain abnormalities concerning for a primary energy deficiency. Whole exome sequencing revealed heterozygotic HMGCS2 variants. HMGCS2 encodes mitochondrial 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) synthase-2 (HMGCS2), which catalyzes the irreversible and rate-limiting reaction of ketogenesis in the mitochondrial matrix. Autosomal recessive HMG-CoA synthase deficiency (HMGCS2D) is characterized by hypoketotic hypoglycemia, vomiting, lethargy, and hepatomegaly after periods of prolonged fasting or illness. A retrospective analysis of the urine organic acid analysis identified 4-hydrox-6-methyl-2-pyrone, a recently reported putative biomarker of HMGCS2D. There was also a relative elevation of plasma acetylcarnitine as previously reported in one case. Our patient highlights a unique presentation of HMGCS2D caused by novel variants in HMGCS2. This is the first report of HMGCS2D with a significantly elevated triglyceride level and decreased HDL cholesterol level at presentation. Given this, we suggest that HMGCS2D should be considered in the differential diagnosis when hypertriglyceridemia, or low HDL cholesterol levels are seen in a child who presents with acidosis, mild ketosis, and mental status changes after illness or prolonged fasting. Although HMGCS2D is a rare disorder with nonspecific symptoms, with the advent of next-generation sequencing, and the recognition of novel biochemical biomarkers, the incidence of this condition may become better understood.

14 Article Clinical Consequences of Hypertriglyceridemia-Associated Proteinuria in Miniature Schnauzers. 2017

Smith, R E / Granick, J L / Stauthammer, C D / Polzin, D J / Heinrich, D A / Furrow, E. ·Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN. ·J Vet Intern Med · Pubmed #28941297.

ABSTRACT: BACKGROUND: Primary hypertriglyceridemia is a common condition in older Miniature Schnauzers that recently has been associated with proteinuria and underlying glomerular pathology, particularly glomerular lipid thromboemboli. Consequences of glomerular disease can include hypertension, thromboembolic disease, and cardiac disease. The incidence of these sequelae in Miniature Schnauzers with hypertriglyceridemia-associated proteinuria (HTGP) is unknown. OBJECTIVE: To investigate prevalence of hypertension, decreased antithrombin III activity, and cardiac disease in Miniature Schnauzers with and without HTGP. ANIMALS: Thirty-two Miniature Schnauzers ≥7 years old. METHODS: Prospective case-control study. Data collected from dogs included a CBC, biochemistry panel, urinalysis, urine protein-to-creatinine ratio, urine cortisol-to-creatinine ratio, serum total thyroxine concentration, fasting serum triglyceride concentration, indirect blood pressure, antithrombin III activity, and serum cardiac troponin I concentration. Results from dogs with HTGP (serum triglyceride concentration ≥ 100 mg/dL and urine protein-to-creatinine ratio >0.5) were statistically compared to normotriglyceridemic, nonproteinuric dogs. RESULTS: Eighteen of the 32 dogs (56%) had primary hypertriglyceridemia. Of those dogs, 8 of 18 had proteinuria. None of the HTGP dogs were azotemic or hypoalbuminemic. Serum albumin concentration, alkaline phosphatase activity, and cholesterol concentration were significantly increased in dogs with HGTP compared to those without HGTP. No increased risk of hypertension, decreased antithrombin III activity, or cardiac disease was noted. Limited data from 8 dogs with HTGP showed no development of hypoalbuminemia or azotemia over a median follow-up period of 18 months. CONCLUSIONS AND CLINICAL IMPORTANCE: Geriatric Miniature Schnauzers with HGTP may have a good prognosis overall, and are not typically azotemic or hypoalbuminemic.

15 Article Hypertriglyceridemia and Pancreatitis-New Evidence That Less Is More. 2017

Lederle, Frank A / Bloomfield, Hanna E. ·Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota. ·JAMA Intern Med · Pubmed #28460101.

ABSTRACT: -- No abstract --

16 Article Effects of MAT9001 containing eicosapentaenoic acid and docosapentaenoic acid, compared to eicosapentaenoic acid ethyl esters, on triglycerides, lipoprotein cholesterol, and related variables. 2017

Maki, Kevin C / Bobotas, George / Dicklin, Mary R / Huebner, Margie / Keane, William F. ·Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Glen Ellyn, IL, USA. Electronic address: kmaki@mbclinicalresearch.com. · Matinas BioPharma, Inc., Bedminster, NJ, USA. · Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Glen Ellyn, IL, USA. · Department of Medicine, University of Minnesota (Retired), Minneapolis, MN, USA. ·J Clin Lipidol · Pubmed #28391875.

ABSTRACT: BACKGROUND: Long-chain omega-3 fatty acid concentrate pharmaceuticals are used in the United States for treatment of severe hypertriglyceridemia (≥500 mg/dL) and are under investigation as adjuncts to statins for lowering cardiovascular risk in patients with high triglycerides (TGs; 200-499 mg/dL). OBJECTIVE: To evaluate MAT9001, an investigational prescription-only omega-3 fatty acid agent containing predominantly eicosapentaenoic acid (EPA) and docosapentaenoic acid, in 42 men and women with fasting TG 200 to 400 mg/dL. METHODS: In this open-label, crossover trial, subjects received MAT9001 and EPA ethyl esters (EPA-EE) in random order. They were housed in a clinical research unit for 2 14-day treatment periods, separated by a ≥35-day washout. Lipoprotein lipids, apolipoproteins (Apos) and proprotein convertase subtilisin kexin type 9 levels were measured before and at the end of each treatment period. RESULTS: MAT9001, compared with EPA-EE, resulted in significantly (P < .05) larger reductions from pretreatment levels for TG (-33.2% vs -10.5%), total cholesterol (-9.0% vs -6.2%), non-high-density lipoprotein cholesterol (-8.8% vs -4.6%), very low-density lipoprotein cholesterol (-32.5% vs -8.1%), Apo C3 (-25.5% vs -5.0%), and proprotein convertase subtilisin kexin type 9 (-12.3% vs +8.8%). MAT9001 also produced a significantly (P = .003) larger reduction in Apo A1 (-15.3% vs -10.2%), but responses for high-density lipoprotein cholesterol (-11.3% vs -11.1%), low-density lipoprotein cholesterol (-2.4% vs -4.3%), and Apo B (-3.8% vs -0.7%), respectively, were not significantly different relative to EPA-EE. CONCLUSIONS: MAT9001 produced significantly larger reductions than EPA-EE in several lipoprotein-related variables that would be expected to favorably alter cardiovascular disease risk in men and women with hypertriglyceridemia.

17 Article Liver X receptor 2017

Heckmann, Bradlee L / Zhang, Xiaodong / Saarinen, Alicia M / Schoiswohl, Gabriele / Kershaw, Erin E / Zechner, Rudolf / Liu, Jun. ·Department of Biochemistry and Molecular Biology. · HEALth Program, Mayo Clinic in Arizona, Scottsdale, Arizona, USA. · Mayo Graduate School, Rochester, Minnesota, USA. · Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. · Institute of Molecular Biosciences, University of Graz, Graz, Austria. · Division of Endocrinology, Mayo Clinic in Arizona, Scottsdale, Arizona, USA. ·JCI Insight · Pubmed #28239648.

ABSTRACT: Liver X receptors (LXRs) are transcription factors essential for cholesterol homeostasis and lipogenesis. LXRα has been implicated in regulating hepatic triglyceride (TG) accumulation upon both influx of adipose-derived fatty acids (FAs) during fasting and stimulation of de novo FA synthesis by chemical agonism of LXR. However, whether or not a convergent mechanism is employed to drive deposition of FAs from these 2 different sources in TGs is undetermined. Here, we report that the G0/G1 Switch Gene 2 (G0S2), a selective inhibitor of intracellular TG hydrolysis/lipolysis, is a direct target gene of LXRα. Transcriptional activation is conferred by LXRα binding to a direct repeat 4 (DR4) motif in the G0S2 promoter. While LXRα

18 Article Glomerular Lesions in Proteinuric Miniature Schnauzer Dogs. 2017

Furrow, E / Lees, G E / Brown, C A / Cianciolo, R E. ·1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minneapolis, MN, USA. · 2 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA. · 3 Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA, USA. · 4 Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA. ·Vet Pathol · Pubmed #28005494.

ABSTRACT: Miniature Schnauzer dogs are predisposed to idiopathic hypertriglyerceridemia, which increases risk for diseases such as pancreatitis and gallbladder mucocele. Recently, elevated triglyceride concentrations have been associated with proteinuria in this breed, although it is difficult to determine which abnormality is primary. Retrospective review of renal tissue from 27 proteinuric Miniature Schnauzers revealed that 20 dogs had ultrastructural evidence of osmophilic globules consistent with lipid in glomerular tufts. Seven of these dogs had lipid thromboemboli in glomerular capillary loops that distorted their shape and compressed circulating erythrocytes. Triglyceride concentrations were reported in 6 of these 7 dogs, and all were hypertriglyceridemic. In addition, glomerular lipidosis (defined as accumulation of foam cells within peripheral capillary loops) was identified in a single dog. The remaining 12 dogs had smaller amounts of lipid that could only be identified ultrastructurally. Neither signalment data nor clinicopathologic parameters (serum albumin, serum creatinine, urine protein-to-creatinine ratio, and blood pressure) differed among the various types of lipid lesions. During the time course of this study, all dogs diagnosed with glomerular lipid thromboemboli were Miniature Schnauzers, underscoring the importance of recognizing these clear spaces within capillary loops as lipid.

19 Article Proteinuria and lipoprotein lipase activity in Miniature Schnauzer dogs with and without hypertriglyceridemia. 2016

Furrow, E / Jaeger, J Q / Parker, V J / Hinchcliff, K W / Johnson, S E / Murdoch, S J / de Boer, I H / Sherding, R G / Brunzell, J D. ·Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55113, USA. Electronic address: furro004@umn.edu. · Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA. · Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA 98195, USA. · Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA 98104, USA. ·Vet J · Pubmed #27256031.

ABSTRACT: Spontaneous hyperlipidemia in rats causes glomerular disease. Idiopathic hypertriglyceridemia (HTG) is prevalent in Miniature Schnauzers, but its relationship with proteinuria is unknown. Decreased activity of major lipid metabolism enzymes, lipoprotein lipase (LPL) and hepatic lipase (HL), may play a role in the cyclic relationship between hyperlipidemia and proteinuria. These enzymes have also not been previously investigated in Miniature Schnauzers. The aims of this study were to determine the relationship between HTG and proteinuria in Miniature Schnauzers and to measure LPL and HL activities in a subset of dogs. Fifty-seven Miniature Schnauzers were recruited (34 with and 23 without HTG). Fasting serum triglyceride concentrations and urine protein-to-creatinine ratios (UPC) were measured in all dogs, and LPL and HL activities were determined in 17 dogs (8 with and 9 without HTG). There was a strong positive correlation between triglyceride concentration and UPC (r = 0.77-0.83, P < 0.001). Proteinuria (UPC ≥ 0.5) was present in 60% of dogs with HTG and absent from all dogs without HTG (P < 0.001). Proteinuric dogs were not azotemic or hypoalbuminemic. Dogs with HTG had a 65% reduction in LPL activity relative to dogs without HTG (P < 0.001); HL activity did not differ. Proteinuria occurs with HTG in Miniature Schnauzers and could be due to lipid-induced glomerular injury. Reduced LPL activity may contribute to the severity of HTG, but further assay validation is required.

20 Article A genome-wide study of lipid response to fenofibrate in Caucasians: a combined analysis of the GOLDN and ACCORD studies. 2016

Irvin, Marguerite R / Rotroff, Daniel M / Aslibekyan, Stella / Zhi, Degui / Hidalgo, Bertha / Motsinger-Reif, Alison / Marvel, Skylar / Srinivasasainagendra, Vinodh / Claas, Steven A / Buse, John B / Straka, Robert J / Ordovas, Jose M / Borecki, Ingrid B / Guo, Xiuqing / Chen, Ida Y D / Rotter, Jerome I / Wagner, Michael J / Arnett, Donna K. ·Departments of aEpidemiology bBiostatistics, University of Alabama at Birmingham, Birmingham, Alabama cDepartment of Statistics, North Carolina State University, Raleigh dUAB Biostatistics, Diabetes Center for Research, University of North Carolina at Chapel Hill School of Medicine eUAB Epidemiology, Center for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina fDepartment of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota gNCState Biostatistics, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts hDepartment of Genetics, Division of Statistical Genomics, Washington University in St Louis, St Louis, Missouri iLaboratory of Statistical and Mathematical Genetics jLaboratory for Biochemistry, Molecular Phenotyping, and Microarray kInstitute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, USA. ·Pharmacogenet Genomics · Pubmed #27002377.

ABSTRACT: BACKGROUND: Fibrates are commonly prescribed for hypertriglyceridemia, but they also lower LDL cholesterol and increase HDL cholesterol. Large interindividual variations in lipid response suggest that some patients may benefit more than others and genetic studies could help identify such patients. METHODS: We carried out the first genome-wide association study of lipid response to fenofibrate using data from two well-characterized clinical trials: the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) Study and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Study. Genome-wide association study data from both studies were imputed to the 1000 Genomes CEU reference panel (phase 1). Lipid response was modeled as the log ratio of the post-treatment lipid level to the pretreatment level. Linear mixed models (GOLDN, N=813 from 173 families) and linear regression models (ACCORD, N=781) adjusted for pretreatment lipid level, demographic variables, clinical covariates, and ancestry were used to evaluate the association of genetic markers with lipid response. Among Caucasians, the results were combined using inverse-variance weighted fixed-effects meta-analyses. The main findings from the meta-analyses were examined in other ethnic groups from the HyperTG study (N=267 Hispanics) and ACCORD (N=83 Hispanics, 138 African Americans). RESULTS: A known lipid locus harboring the pre-B-cell leukemia homeobox 4 (PBX4) gene on chromosome 19 is important for LDL cholesterol response to fenofibrate (smallest P=1.5×10). The main results replicated with nominal statistical significance in Hispanics from ACCORD (P<0.05). CONCLUSION: Future research should evaluate the usefulness of this locus to refine clinical strategies for lipid-lowering treatments.

21 Article Influence of race/ethnicity on cardiovascular risk factors in polycystic ovary syndrome, the Dallas Heart Study. 2016

Chang, Alice Y / Oshiro, June / Ayers, Colby / Auchus, Richard J. ·Division of Endocrinology, Metabolism, Diabetes and Nutrition, Mayo Clinic, Rochester, MN, USA. · Scientific Publications, Mayo Clinic, Rochester, MN, USA. · Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Division of Metabolism, Diabetes, and Endocrinology, University of Michigan, Ann Arbor, MI, USA. ·Clin Endocrinol (Oxf) · Pubmed #26608823.

ABSTRACT: OBJECTIVE: Polycystic ovarian syndrome (PCOS) is estimated to affect up to 20% of women. PCOS is associated with insulin resistance and cardiovascular (CV) risk factors. We aimed to evaluate the impact of race/ethnicity on the prevalence of CV risk factors and subclinical predictors of CV events. DESIGN: Cross-sectional analysis of data collected by the Dallas Heart Study, an urban, population-based cohort oversampled for blacks. PATIENTS: A previously described cohort of women with PCOS and control subjects of the same racial/ethnic group, matched for age and body mass index. MEASUREMENTS: Hormonal and clinical measures associated with PCOS and CV risk factors. RESULTS: The study included 117 women with PCOS and 204 controls. Women with PCOS had significant differences across racial/ethnic groups in the prevalence of hypertension, hypercholesterolaemia, hypertriglyceridaemia and impaired fasting glucose (P < 0·05). Controls showed significant racial/ethnic differences in the prevalence of hypertension and impaired fasting glucose (P < 0·05). The odds of hypertension were significantly greater among women with PCOS than controls after adjusting for race/ethnicity (odds ratio, 1·50 [95% CI, 1·03-2·30]; P = 0·04). However, we did not see an interaction of race/ethnicity that significantly changed CV risk factor prevalence between PCOS and controls. In addition, subclinical measures of CV disease were not different between women with PCOS vs controls, even among hypertensive women. CONCLUSIONS: Race/ethnicity affects the prevalence of CV risk factors for women with and without PCOS. However, race/ethnicity does not interact with PCOS to additionally increase CV risk factor prevalence or subclinical CV disease.

22 Article Relation between vitamin D status and nonalcoholic fatty liver disease in children. 2015

Hourigan, Suchitra K / Abrams, Stephanie / Yates, Katherine / Pfeifer, Kim / Torbenson, Michael / Murray, Karen / Roth, Christian L / Kowdley, Kris / Scheimann, Ann O / Anonymous6630821. ·*Johns Hopkins School of Medicine, Baltimore, MD †Pediatric Specialists of Virginia, Fairfax, VA ‡Baylor College of Medicine, Houston, TX §Johns Hopkins Bloomberg School of Public Health, Baltimore, MD ||Mayo Clinic, Rochester, MN ¶Seattle Children's #Seattle Medical Center, Seattle, WA. ·J Pediatr Gastroenterol Nutr · Pubmed #25710716.

ABSTRACT: OBJECTIVES: In adults, vitamin D deficiency is common in patients with nonalcoholic fatty liver disease (NAFLD) and has been associated with the severity of histology. There are known differences between adult and pediatric NAFLD, with little data regarding the relation between vitamin D and pediatric NAFLD. The aim of the present study was to examine the relation between vitamin D levels and NAFLD in children. METHODS: Clinical and histological data were used from children ages 2 to 18 years with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network studies. 25(OH) vitamin D levels were measured from serum. Data examined included demographics, anthropometrics, laboratory markers, and liver histology. Data were analyzed using 3 categories of vitamin D level: deficient (≤ 20 ng/mL), insufficient (21-29 ng/mL), and sufficient (≥ 30 ng/mL). RESULTS: A total of 102 children were studied. There was a high prevalence (80/102, 78%) of vitamin D deficiency or insufficiency; however, there were no significant associations between vitamin D level and the histological characteristics or severity of NAFLD. Significantly higher levels of triglycerides were found in those with vitamin D deficiency (P = 0.004), but there was no association with other features of the metabolic syndrome. CONCLUSIONS: There is a high prevalence of vitamin D deficiency and insufficiency in children with biopsy-proven NAFLD; however, no association was found between vitamin D deficiency and the severity of disease on biopsies. This differs from adult NAFLD studies in which vitamin D deficiency correlates with histological severity, suggesting differences in the risk factors for or consequences of pediatric NAFLD.

23 Article Relationship Between Triglyceride Tolerance, Body Mass Index, and Fat Depots in Hospitalized Patients Receiving Parenteral Nutrition. 2015

Frazee, Erin N / Nystrom, Erin M / McMahon, M Molly / Williamson, Eric E / Miles, John M. ·Department of Pharmacy, Mayo Clinic, Rochester, Minnesota. · Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Metabolism, Mayo Clinic, Rochester, Minnesota. · Department of Radiology, Mayo Clinic, Rochester, Minnesota. · Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Metabolism, Mayo Clinic, Rochester, Minnesota miles.john@mayo.edu. ·JPEN J Parenter Enteral Nutr · Pubmed #24920321.

ABSTRACT: BACKGROUND: Hypertriglyceridemia has been associated with adverse outcomes in patients receiving intravenous fat emulsions (IVFEs), but little is known about its prevalence and causes. MATERIALS AND METHODS: The study investigated whether a relationship exists between body mass index (BMI) and triglyceride tolerance in parenterally fed patients. We conducted a retrospective analysis of 287 adults receiving parenteral nutrition to determine whether patients with very low BMI (VLBMI, <16 kg/m(2)) tolerate IVFEs better than do patients with low BMI (LBMI, 16-18.4 kg/m(2)), normal-weight patients (NBMI, 18.5-24.9 kg/m(2)), and overweight/obese patients (HBMI, ≥25 kg/m(2)). RESULTS: The median triglyceride concentration during IVFE was significantly lower in VLBMI patients at 107 mg/dL compared with 124 mg/dL in non-VLBMI patients (P = .016), despite higher lipid infusion rates in the VLBMI group. There was a significant association between triglycerides and BMI in the aggregate cohort (R = 0.2375, P < .0001), with the highest frequency of hypertriglyceridemia occurring in HBMI patients despite relatively lower lipid and energy supply. In a subset of VLBMI patients (n = 36) who had an abdominal computed tomography scan, there was 25- to 100-fold variability in the size of the abdominal adipose tissue depots. In this subgroup, triglyceride concentrations correlated with visceral fat but not subcutaneous abdominal fat. CONCLUSIONS: In summary, patients with VLBMI have lower triglyceride concentrations during IVFEs than do other individuals, but there is considerable variability in triglycerides and body fat in this group. Caution should be employed with the use of IVFEs, especially in HBMI patients.

24 Article Metreleptin for metabolic disorders associated with generalized or partial lipodystrophy. 2014

Simha, Vinaya. ·a Mayo Clinic , 200 First St SW, Rochester, MN 55905, USA. ·Expert Rev Endocrinol Metab · Pubmed #30736159.

ABSTRACT: Lipodystrophy is a group of acquired and inherited disorders characterized by selective loss of adipose tissue. Despite wide genotypic and phenotypic variety, many patients with lipodystrophy have similar metabolic complications including insulin resistance, diabetes mellitus, hypertriglyceridemia and hepatic steatosis. Often, these metabolic abnormalities are severe and difficult to treat with conventional glucose and lipid-lowering therapies. Lack of adipose tissue also results in marked hypoleptinemia, and there has recently been much interest in using leptin-replacement therapy to treat the metabolic complications of lipodystrophy. Administration of metreleptin, the human recombinant leptin analogue, has been shown in prospective, open-label studies to improve glucose control, dyslipidemia and steatohepatitis. This article summarizes the current evidence for the safety and efficacy of leptin-replacement therapy in patients with lipodystrophy.

25 Article A double-blind randomized trial of fish oil to lower triglycerides and improve cardiometabolic risk in adolescents. 2014

Gidding, Samuel S / Prospero, Carol / Hossain, Jobayer / Zappalla, Frances / Balagopal, Prabhakaran Babu / Falkner, Bonita / Kwiterovich, Peter. ·Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE; Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA. Electronic address: samuel.gidding@nemours.org. · Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE. · Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE; Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA. · Department of Research, The Nemours Children's Clinic, Wilmington, DE; Mayo Clinic College of Medicine, Rochester, MN. · Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA. · Department of Pediatrics, Johns Hopkins University, Baltimore, MD. ·J Pediatr · Pubmed #25008950.

ABSTRACT: OBJECTIVES: To determine the efficacy of 4 g/day fish oil to lower triglycerides and impact lipoprotein particles, inflammation, insulin resistance, coagulation, and thrombosis. STUDY DESIGN: Participants (n = 42, age 14 ± 2 years) with hypertriglyceridemia and low-density lipoprotein (LDL) cholesterol <160 mg/dL were enrolled in a randomized, double-blind, crossover trial comparing 4 g of fish oil daily with placebo. Treatment interval was 8 weeks with a 4-week washout. Lipid profile, lipoprotein particle distribution and size, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, fibrinogen, plasminogen activator inhibitor-1, and thrombin generation were measured. RESULTS: Baseline lipid profile was total cholesterol 194 (5.4) mg/dL (mean [SE]), triglycerides 272 (21) mg/dL, high-density lipoprotein cholesterol 39 (1) mg/dL, and LDL cholesterol 112 (3.7) mg/dl. LDL particle number was 1614 (60) nmol/L, LDL size was 19.9 (1.4) nm, and large very low-density lipoprotein/chylomicron particle number was 9.6 (1.4) nmol/L. Triglycerides decreased on fish oil treatment but the difference was not significant compared with placebo (-52 ± 16 mg/dL vs -16 ± 16 mg/dL). Large very low-density lipoprotein particle number was reduced (-5.83 ± 1.29 nmol/L vs -0.96 ± 1.31 nmol/L; P < .0001). There was no change in LDL particle number or size. There was a trend towards a lower prothrombotic state (lower fibrinogen and plasminogen activator inhibitor-1; .10 > P > .05); no other group differences were seen. CONCLUSIONS: In children, fish oil (4 g/day) lowers triglycerides slightly and may have an antithrombotic effect but has no effect on LDL particles.

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