Eruptive xanthomas in a patient with severe hypertriglyceridemia:A case report

BACKGROUND Xanthomatosis,a metabolic disorder causing yellow growths(xanthomas),poses challenges in lipid metabolism.This case study introduces the first documented instance within China's Yi population,emphasizing the need to explore dietary habits and treatment strategies tailored to this specific community.CASE SUMMARY Xanthomatosis is a metabolic disorder where lipid metabolism goes awry,resulting in the development of yellowish growths called xanthomas.A male patient,47 years of age,from China's Yi population,who is obese,visited our dermatology clinic complaining of widespread,non-painful rashes that have been present for two weeks.The patient works as a chef and has a diet that frequently includes oily and greasy foods.This case represents the initial documentation of xanthomatosis within the Yi population in China,offering a theoretical foundation for understanding dietary patterns and treatment options specific to the Yi community.CONCLUSION The first report of xanthomatosis in the Yi population in China lays a theoretical foundation for understanding Yi dietary patterns and treatment.

Clinical study of neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio in hypertriglyceridemia-induced acute pancreatitis and acute biliary pancreatitis with persistent organ failure

BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are novel inflammatory indicators that can be used to predict the severity and prognosis of various diseases.We categorize acute pancreatitis by etiology into acute biliary pancreatitis(ABP)and hypertriglyceridemia-induced acute pancreatitis(HTGP).AIM To investigate the clinical significance of NLR and PLR in assessing persistent organ failure(POF)in HTGP and ABP.METHODS A total of 1450 patients diagnosed with acute pancreatitis(AP)for the first time at Shanxi Bethune Hospital between January 2012 and January 2023 were enrolled.The patients were categorized into two groups according to the etiology of AP:ABP in 530 patients and HTGP in 241 patients.We collected and compared the clinical data of the patients,including NLR,PLR,and AP prognostic scoring systems,within 48 h of hospital admission.RESULTS The NLR(9.1 vs 6.9,P<0.001)and PLR(203.1 vs 160.5,P<0.001)were significantly higher in the ABP group than in the HTGP group.In the HTGP group,both NLR and PLR were significantly increased in patients with severe AP and those with a SOFA score≥3.Likewise,in the ABP group,NLR and PLR were significantly elevated in patients with severe AP,modified computed tomography severity index score≥4,Japanese Severity Score≥3,and modified Marshall score≥2.Moreover,NLR and PLR showed predictive value for the development of POF in both the ABP and HTGP groups.CONCLUSION NLR and PLR vary between ABP and HTGP,are strongly associated with AP prognostic scoring systems,and have predictive potential for the occurrence of POF in both ABP and HTGP.

Splenic Vein Thrombosis as a Complication of Hypertriglyceridemia-Induced Acute Pancreatitis

Background: Acute pancreatitis (AP) is an extensive inflammation condition that may lead to local and systemic complications, ranging from mild edematous peripancreatic fluid collection to multiorgan failure and death. Aim: To report the case of the patient with the complications that happened and the presented management. Case presentation: A 37-year-old female patient presented with acute necrotizing pancreatitis secondary to hypertriglyceridemia. During hospitalization, the patient developed severe ileus with splenic vein thrombosis. She was treated conservatively with Intravenous (IV) fluids, insulin infusion, anticoagulant, pain relief medication and antibiotics. Discussion: This case of pancreatitis induced splenic vein thrombosis (PIVST) was treated supportively with outstanding improvement of the patient’s symptoms. Conclusion: Acute pancreatitis can be complicated by splenic vein thrombosis that can be self-limited and treated with conservative measures.

Genetic Screening of the Lipoprotein Lipase Gene for Mutations in Chinese Subjects with or without Hypertriglyceridemia

Objective： To investigate the association between the mutations in lipoprotein lipase gene and hypertriglyceridemia （HTG）. Methods： The lipoprotein lipase （LPL） gene was screened for mutations in 386 Chinese subjects with （108 cases in the HTG group） or without HTG （278 cases in the control group）, by single-strand conformation polymorphism （SSCP） analysis and DNA sequencing. Results： One novel silent mutation L103L, one missense mutation P207L, three splicing mutations Int3/3＇ -ass/C（-6）→T, and the common S447X polymorphism has been identified in the whole coding region and exon-intron junctions of the LPL gene were examined. Heterozygous P207L found in the HTG group was the first case reported in Asia and subsequently another P207L heterozygote was found in the proband＇s family, all of which suggested that P207L was one of the causes of familial combined hyperlipidemia, but was not so prevalent as that in French Canadian. Int3/3＇-ass/C（-6）→T was found in both groups in the present study although it was regarded as a pathogenic variant to HTG earlier on. Moreover about the beneficial polymorphism S447X, there was also some supportive evidence that the levels of triglycerides （TG） in S447X carriers were significantly lower than noncarders in the subjects without HTG. Conclusions： The association between the LPL variants and HTG is quite complicated and versatile, genotyping of LPL in a larger-scale screening should be necessary and justifiable.

Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis

AIM： To investigate the effect of admission hypertriglyceridemia （HTG） on the episodes of severe acute pancreatitis （SAP）. METHODS： One hundred and seventy-six patients with SAP were divided into HTG group （n = 45） and control group （n = 131） according to admission triglyceride （TG） ≥ 5.65 mmol/L and 〈 5.65 retool/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson＇ s score, acute physiology and chronic heath evaluation Ⅱ （APACHE Ⅱ） score, Balthazar＇s computed tomography （CT） score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE Ⅱ score was analyzed. RESULTS： SAP patients with HTG were younger （40.8 ± 9.3 years vs 52.6 ± 13.4 years, P 〈 0.05） with higher etiology rate of overeating, high-fat diet （40.0% vs 14.5%, P 〈 0.05） and alcohol abuse （46.7% vs 23.7%, P 〈 0.01）, incidence rate of hypocalcemia （86.7% vs 63.4%, P 〈 0.01） and hypoalbuminemia （84.4% vs 60.3%, P 〈 0.01）, 24-h APACHE Ⅱ score （13.6 ± 5.7 vs 10.7 ± 4.6, P 〈 0.01） and admission serum glucose （17.7 ± 7.7 vs 13.4 ± 6.1, P 〈 0.01）, complication rate of renal failure （51.1% vs 16.8%, P 〈 0.01）, shock （37.9% vs 14.5%, P 〈 0.01） and infection （37.4% vs 18.3%, P 〈 0.01） and mortality （13.1% vs 9.1%, P 〈 0.01）. Logistic regression analysis showed a positive correlation between admission TG and 24-h APACHE Ⅱ score （r = 0.509, P = 0.004）.CONCLUSION： The clinical features of SAP patients with HTG are largely consistent with previous studies, HTG aggravates the episodes of SAP.

Hypertriglyceridemia-induced pancreatitis: A case-based review

Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemJa and how it can cause pancreatitis. We outline how to investigate and manage such patients. A 35 year old man presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. There was no history of alcohol consumption and biliary imaging was normal. The only relevant past medical history was that of mild hyperlipidemia, treated with diet alone. Physical exam revealed epigastric tenderness, right lateral rectus palsy, lipemia retinalis, bitemporal hemianopsia and a delay in the relaxation phase of his ankle reflexes. Subsequent laboratory investigation revealed marked hypertriglyceridemia and panhypopituarism. An enhanced CT scan of the head revealed a large suprasellar mass impinging on the optic chiasm and hypothalamus. The patient was treated supportively; thyroid replacement and lipid lowering agents were started. He underwent a successful resection of a craniopharyngioma. Postoperatively, the patient did well on hormone replacement therapy. He has had no further attacks of pancreatitis. This case highlights many of the factors involved in the regulation of triglyceride metabolism. We review the common causes of hypertriglyceridemia and the proposed mechanisms resulting in pancreatitis. The incidence and management of hypertriglyceridemiainduced pancreatitis are also discussed.

Severe acute pancreatitis due to tamoxifen-induced hypertriglyceridemia with diabetes mellitus

The side effects of tamoxifen are generally mild, including the effect on lipoprotein metabolism. However, there are few cases of severe tamoxifen induced hypertriglyceridemia. Hypertriglyceridemia is a marked risk factor for acute pancreatitis and approximately 2% to 5% of cases of acute pancreatitis are related to drugs. We report on tamoxifen-induced hypertriglyceridemia and acute pancreatitis in a 40 years old woman with type 2 diabetes mellitus occurred by dexamethasone. She was treated with insulin infusion and fenofibrate, and goserelin acetate was started instead of tamoxifen after discharge from the hospital. Also, probable pathogenic hypotheses about the correlation between tamoxifen and dexamethasone induced type 2 diabetes mellitus on severe acute pancreatitis are provided. Clinicians should take care of risks of severe acute pancreatitis on using tamoxifen, especially for patients with dexamethasone induced diabetes mellitus. These individuals should undergo pre-post tamoxifen lipid screening and careful history taking of drugs, including dexamethasone.

case of familial hyperlipoproteinemia type Ⅲ hypertriglyceridemia induced acute pancreatitis: role for outpatient apheresis maintenance therapy

Hypertriglyceridemic pancreatitis(HTGP) accounts for up to 10% of acute pancreatitis presentations in nonpregnant individuals and is the third most common cause of acute pancreatitis after alcohol and gallstones. There are a number of retrospective studies and case reports that have suggested a role for apheresis and insulin infusion in the acute inpatient setting. We report a case of HTGP in a male with hyperlipoproteinemia type Ⅲ who was treated successfully with insulin and apheresis on the initial inpatient presentation followed by bi-monthly outpatient maintenance apheresis sessions for the prevention of recurrent HTGP. We also reviewed the literature for the different inpatient and outpatient management modalities of HTGP. Given that there are no guidelines or randomized clinical trials that evaluate the outpatient management of HTGP, this case report may provide insight into a possible role for outpatient apheresis maintenance therapy.

Postprandial hyperglycemia and postprandial hypertriglyceridemia in type 2 diabetes

Postprandial glucose level is an independent risk factor for cardiovascular disease that exerts effects greater than glucose levels at fasting state, whereas increase in serum triglyceride level, under both fasting and postprandial conditions, contributes to the development of arteriosclerosis. Insulin resistance is a prevailing cause of abnormalities in postabsorptive excursion of blood glucose and postprandial lipid profile. Excess fat deposition renders a vicious cycle of hyperglycemia and hypertriglyceridemia in the postprandial state, and both of which are contributors to atherosclerotic change of vessels especially in patients with type 2 diabetes mellitus. Several therapeutic approaches for ameliorating each of these abnormalities have been attempted, including various antidiabetic agents or new compounds targeting lipid metabolism.

Diagnostic evaluation of acute pancreatitis in two patients with hypertriglyceridemia

We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.

Association of PPARγand AGTR1 Polymorphisms with Hypertriglyceridemia in Chinese Population

Hypertriglyceridemia （HTG） is an important metabolic disease and strongly associated with the development of hypertension, atherosclerosis,coronary artery disease, and type 2 diabetes mellitus（T2DM）. HTG risk is affected by various factors and might occur owing to the complex synergistic interaction between the genetic background and environmental factors;.

Two male study groups with adiposity and hypertriglyceridemia were at risk for hypertension and alcohol use declined renal endothelium

Men who attended a Bavarian General Medicine Practice were confidentially invented here. Two male study groups were enrolled to characterize adiposity or hypertriglyceridemia showing that these men were at baseline risk for hypertension [1]. Adverse alcohol consumption mediated dysfunction of renal endothelium as shown here and before [1]. This study found that alcohol use aggravated dyslipidemia, fatty liver disease and critical fasting blood glucose of obese men predicting then late hepatorenal disorders. Overall, two male study groups showed a relevant proportion of men who reported alcohol consumption showing then critical morning urines indicating dysfunction of renal endothelium. The present report looked also at healthy men who reported positive lifestyle behaviour and at men with nonalcohol adiposity and nonalcohol hypertriglyceridemia who then showed normal morning urines indicating functional renal endothelium. Relatively young men at risk were motivated to replace adverse alcohol use by healthy liquids without alcohol and by higher quality of food.

Spectrum of Hypertriglyceridemia at the Onset of Type 2 Diabetes in Ouagadougou

Introduction: Hypertriglyceridemia is a frequent dyslipidemia in type 2 diabetes. We aimed to determine its prevalence, its typology, and its associated factors in newly type 2 diabetes patients in Ouagadougou. Material and Method: This cross-sectional, descriptive and analytic study has been performed from May 2015 to June 2016 in the Internal medicine department in Yalgado Ouédraogo teaching hospital, Ouagadougou. An accidental sample of newly type 2 diabetes outpatients, na?ve of antidiabetics therapy was studied. A 12-hour fasting triglyceridemia was performed;hypertriglyceridemia was defined for triglyceridemia > 1.5 g/L (1.7 mmol/L). Data were analyzed with Epi info 7.1.5.0. Proportions and means were compared respectively with Khi2 or Fisher’s test and Student’s test with a significance of p Results: One hundred and three patients, i.e. 35 (34%) men and 68 (66%) women were included. The sex ratio was 0.51 and the mean age 49.3 ± 10.1 years [limits: 24 and 70]. The mean value of triglyceridemia was 1.8 ± 1.7 mmol/L [limits: 0.5 and 14.9]. Hypertriglyceridemia was reported in 32 patients (31.1%): minor (11.30 mmol/L) in one (3.1%) patients. Hypertriglyceridemia’s phenotype was commonly integrated into a mixed dyslipidemia;it was often combined with a total cholesterolemia increase and a HDL cholesterolemia decrease. In bivariate analysis, hyperglycemia was associated with severe hyperglycemia (p = 0.006) and renal failure (p = 0.03). Conclusion: Hypertriglyceridemia in type 2 diabetes is frequent and often combined with other lipids disorders. It may need an optimal care.

Rare Case of Surviving Infant with Strawberry Yoghurt like Blood Diagnosed to Be Infantile Hypertriglyceridemia at 1 Month Old: A Case Report

Background: Hypertriglyceridemia in children means increased plasma fasting Triglyceride levels above the 95th percentile for age and sex. For children aged 0 to 9 years, a triglyceride level greater than or equal to 100 mg/dl is considered above the 95th percentile. Hypertriglyceridemia can be mild to borderline high, moderate to high, very high, severe and very severe (>2000 mg/dl). We present the case of a 1 month and 3 weeks old baby who presented with difficulty in breathing. It was accidentally found to have strawberry yoghurt like blood during phlebotomy, of which upon investigation had very high triglyceride levels of >2000 mg/dl. Case Presentation: 1 month and 3 weeks old female baby, admitted as referral from nearby health centre presenting with difficulty in breath, her blood sample was incidentally found to appear as strawberry yoghurt like. Clinically the infant had features suggestive of respiratory distress, with no other systemic abnormalities noted. Chest X-ray that was done had features of pneumonia. The working diagnosis on admission was Pneumonia, Electrolyte imbalance. The strawberry yoghurt like blood raised suspicions of hypertriglyceridemia. Our triglyceride levels in the infant were very high at 136 mmol/l (12,046 mg/dl). The patient was treated with IV antibiotics for pneumonia, electrolytes were corrected and Rosuvastatin was started. This patient improved remarkably and was discharged with Rosuvastatin. Lipid profile was followed up for 4 consecutive months in our outpatient clinic with a drastic drop in triglyceride and cholesterol. Conclusion: We report a case of infantile hypertriglyceridemia found accidentally during phlebotomy. Despite limited resource to evaluate further on primary cause of this condition as well as family’s poor economic status to seek further medical evaluation outside the country, this case report raises awareness on how to deal with this condition in a low resource setting. It also highlights the role of statins in the treatment of hypertriglyceridemia.

Hypertriglyceridemia:a case report from diagnostic laboratory,Barasat,West Bengal,India

Hypertriglyceridemia is defined as an abnormal concentration of triglyceride in the blood and has been associated with atherosclerosis,even in the absence of hypercholesterolemia.This case report is of 40-year-old man diagnosed to have hypertriglyceridemia who attended for routine screening in our diagnostic laboratory at Barasat.He was nonsmoker,non-alcoholic,had a reasonable diet with abundant fruits and vegetables,and was on regular exercise.He was not taking any lipid lowering medications.He hailed from Barasat,and was employed in Government sector in Barasat and policeman by profession.His father died at the age of 57 years in a heart attack;but his mother is healthy and now almost 62 years of age,and he has two brothers one elder and another younger to him,both are healthy.His blood pressure was normal,his body-mass index was 27,and his waist circumference was 96 cm and hip circumference was 103.His waist/hip ratio was 0.932.The Biochemical analyses were as follows- Fasting Glucose:186 mg/dL,Total Cholesterol:90 mg/dL,Triglycerides:372 mg/dL,High-density cholesterol:3.80 mg/dL,Low-density cholesterol:2.90 mg/dL,VLDL:83.20 mg/dL,Cholesterol/HDL-C ratio:23.6:1,LDL-C/HDL-C:0.07:1.This study revealed the increased prevalence of dyslipidemia to be more prevalent in 31-40 year males,suggesting that this group is at an increased risk of developing CAD leading to young infarcts.Combination lifestyle therapies i.e.,enhanced physical activity and dietary modification and therapeutic intervention would help us in the treatment and management of dyslipidemia.

Association of obesity anthropometric indices with hypertension,diabetes mellitus and hypertriglyceridemia in apparently healthy adult Nigerian population

BACKGROUND Hypertension,hyperglycemia and hypertriglyceridemia are chronic conditions associated with cardiometabolic diseases.Certain anthropometric indices are known to predict them.AIM To investigate the association of anthropometric indices with these chronic diseases and which anthropometric index predicts them best.METHODS In this study,221 apparently healthy individuals who never received treatments for cardiovascular disease(CVD),diabetes or other chronic diseases participated.The age of the participants ranged from 20-75 years with mean age of 36.9±11.4 years.The risk factors of these diseases namely systolic blood pressures(SBP)and diastolic blood pressures(DBP),fasting blood glucose(FBG)and triglycerides(TG)were determined for all the participants using standard clinical procedures.The obesity anthropometric indices,waist circumference,waist-to-height ratio,waist-to-hip ratio and body mass index as well as abdominal height(AH)and body surface index were determined.The association between each of them with the risk factors were determined by the Pearson correlation method.RESULTS From the results,it was found that AH showed superiority over the rest for SBP(r=0.301,P<0.01),DBP(r=0.370,P<0.01),FBG(r=0.297,P<0.01)and TG(r=0.380,P<0.01).Using the receiver operating characteristic curves,cut-off values of AH for SBP,DBP,FBG and TG were determined to be 24.75 cm,24.75 cm,25.25 cm and 24.75 cm respectively.CONCLUSION The indices of anthropometry used in this study correlated significantly with the studied CVD risk factors,with AH emerging as the most predictive.

Impact of Switch to Fosamprenavir and Addition of Lovaza^®for Treatment of Hypertriglyceridemia in HIV-Infected Subjects on Antiretroviral Therapy

Background: Managing hypertriglyceridemia in HIV-infected patients often requires multiple pharmacologic strategies. Many protease inhibitors (PIs), one of 6 classes of drugs used to treat HIV, have been associated with hypercholesterolemia and drug interactions. For this study, we examined a dual strategy to manage hypertriglyceridemia in HIV-infected patient taking PIs: 1) switching patients to fosamprenavir (FPV), a PI with fewer drug interactions, and 2) adding prescription fish oil (LOVAZA?), which has been shown to reduce triglycerides. Methods: This multicenter, 24-week study enrolled 36 patients virologically suppressed (HIV-1 RNA <50 copies/mL) on PI-containing therapy with screening triglyceride levels of 200 - 1200 mg/dL and LDL cholesterol levels ≤160 mg/dL. At baseline, patients were switched to ritonavir (RTV)-boosted fosamprenavir (FPV 1400 mg/RTV 100 mg QD) and any lipid-lowering agents were stopped. At Week 6, LOVAZA 4 g QD was added. Results: Five patients prematurely discontinued due to adverse events (2), non-compliance, lost-to-follow up, and protocol violation. Median triglyceride concentration was 303 mg/dL at screening, 262 mg/dL at baseline, 290 mg/dL at Week 6 (+8% from baseline), and 218 mg/dL at Week 24 (–30% from Week 6). At Week 24, 39% (12/31) of patients had triglycerides <200 mg/dL. Among patients reaching Week 24, 100% (31/31) and 90% (28/31) had HIV-1 RNA <400 and <50 copies/mL, respectively. Conclusions: In this study, a switch to FPV/RTV followed by LOVAZA decreased median triglyceride levels and modestly increased the percentage of patients with triglyceride levels <200 mg/dL while maintaining virologic suppression in HIV-infected subjects with hypertriglyceridemia. Our data suggest that baseline PI may affect the likelihood of achieving triglycerides <200 mg/dL after 18 weeks on study. A larger study would be needed to understand the relative contributions of choice of protease inhibitor and LOVAZA to triglyceride concentrations in HIV-infected patients.

Adiponectin Receptor 1 Single Nucleotide Polymorphism Is Highly Associated with Hypertriglyceridemia in Asian Male—A Novel Genetic Screening to Reduce Risk of Cerebrovascular Disease

Background: Adiponectin is involved in regulating both glucose and fatty acid. Associations of the known adiponectin receptors 1 (ADIPOR1) single nucleotide polymorphism (SNP) with diabetes have been demonstrated while hypertriglyceridemia is frequently associated with cerebrovascular disease (CVD) among diabetes. Triglyceride metabolism was also reported to be different between genders and estrogen was observed to interfere with adiponectin effects via ADIPOR1. It seems important to investigate whether the ADIPOR1 SNP variants may be significant determinants in triglyceride metabolism and hence be a risk of CVD in specific gender. Methods: A survey was performed on random self-reported healthy subjects aged 35 and above with their biochemical data collected. Genotyping for ADIPOR1 SNP (rs1342387) was carried out using?TaqMan Genotyping Assays. Interviews were also conducted regarding stress, adverse diet behavior and exercise. Multivariable logistic regression analyses were performed to identify the strongest contributing variables. Findings: The ADIPOR1 minor allele carrier (T/T and T/C) had significantly (p?= 0.02) higher TG mean compared to homozygous (C/C) major alleles. TG difference was significantly higher in male (p?= 0.02) with a larger difference in mean, whereas the difference disappeared among female (p?= 0.32). Multivariate logistic regression analyses were performed by defining abnormal TG based on NCEP criteria of metabolic syndrome, and when all life style variables were entered in the model with ADIPOR1, only the ADIPOR1 inmale showed significant (p?= 0.03) and very high association with abnormal TG (Exp(β) 16.31). Discussion: The findings provide sample evidence of a relation between ADIPOR1 SNP minor allele carrier and high TG concentrations in male. The association of abnormal TG and ADIPOR1 is much stronger than that compared to life style. The implications of this survey may be further extend to identifying the genetic risk of abnormal TG at young age and reduce the CVD incidence by early intervention.

Can Purified Omega-3 Polyunsaturated Fatty Acids Supplementation Act Blood Pressure Levels in Untreated Normal-High Blood Pressure Subjects with Hypertriglyceridemia?

Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) from fish and fish oils appear to protect against coronary heart disease: their dietary intake is in fact inversely associated with cardiovascular disease morbidity/mortality in population studies. Recent evidence suggests that at least a part of this protective effect is mediated by a relatively small but significant decrease in blood pressure (BP) level. In fact, omega-3 PUFAs exhibit wide-ranging biological actions that include regulating both vasomotor tone and renal sodium excretion, partly competing with omega-6 PUFAs for common metabolic enzymes and thereby decreasing the production of vasoconstrictor rather than vasodilator and anti-inflammatory eicosanoids. PUFAs also reduce angiotensin-converting enzyme (ACE) activity, angiotensin II formation. We retrospectively evaluated the long-term effect of a omega-3 PUFAs supplementation on the blood pressure level of 91 hypertriglyceridemic subjects with untreated normal-high blood pressure that were prescribed a 3 grams omega-3 PUFAs supplementation in order to improve their plasma lipid pattern. After 24 months of treatment, systolic blood pressure (SBP) meanly decreased by 2.6 +/- 2.5 mmHg (p = 0.001) and diastolic blood pressure (DBP) by 1.4 +/- 3.1 mmHg (p < 0.001), while basal heart rate decreased by 4.1 +/- 4.6 bpm (p < 0.001). Both SBP and DBP reduction were significantly related to the baseline SBP (p < 0.001) and DBP (p < 0.001), respectively. Diastolic blood pressure change was also inversely related to the patient’s age (p = 0.004). No significant difference was perceived in the metabolic syndrome subgroup. In our retrospective study, highly purified omega-3 PUFAs long-term supplementation is associated with a significant reduction in SBP, DBP, and basal heart rate in hypertriglyceridemic patients with normal-high blood pressure. The main determinants of the omega-3 PUFAs anti-hypertensive effect appear to be the basal blood pressure level and age. Future research will clarify if omega-3 PUFAs supplementation could improve the antihypertensive action of specific blood pressure lowering drug classes and of statins.

Moderate Hypertriglyceridemia Revealed by Acute Chest Syndrome, a Milky Appearance Serum and Prior History of Recurrent Acute Pancreatitis in a Type 2 Diabetes Black Patient: A Case Report

Although the “triglyceride paradox” states that hypertriglyceridemia is less frequent in Blacks and the risk of pancreatitis increases with severe hypertriglyceridemia, we herein report on a case of moderate hypertriglyceridemia revealed by an acute chest syndrome and a milky appearance serum in a 47-year-old type 2 diabetes black patient with prior history of recurrent acute pancreatitis. In addition to insulin therapy and coronary angioplasty, the combination of a statin and a fibrate resulted two months later in a substantial improvement in triglyceride levels and a normal serum appearance.