Another video in the series on hypertriglyceridemia. What? Wait a minute.
What is that? "Hyper" meaning too many; "triglycerides" meaning fat. It's the stuff
you have on saddlebags, the subcutaneous fat. But the biochemist has this. Think
this picture up in the right. A glycerol molecule holding three fatty
acids together...that's what that big fat storage is. What's inside fat cells? We did
another video just recently where we looked at what tends to cause it. Well
we're going to talk about that a little bit today and where you see it, how
common is it,
and here's some basic step. Standard definitions for hypertriglyceridemia.
Normal - less than 150. You know I'd rather not see them that high but that's the
lab normal that you see in medical standards these days. Borderline high is
150 to 200. High is 200 above. And then you can get them very very high 500 and
high. Now where do you see this and how often is it? Well you can see it from
genetic factors, especially with the really high (the 250 and 500 and above),
those are usually genetic problems. But you see it really commonly as we age. You
see it with gender. You see it with men. You see it with lower educational status,
lower socioeconomic status, for poorer folks. In other words, guess what? It tends
to mimic insulin resistance. You see it with increased obesity as well. Let's
actually, take a look at some of this. So again, as you see, you've got the glycerol
molecule holding three fatty acids together. Here are a couple of different
charts off the internet showing the men and women by age. And as you see with
women, you tend to have it 10 percent, 5 percent or less up until age 30, 40, even
50. But with men in the 30s and even in the 40s, you start getting up 25, 30
percent or more. Just like with men, you tend to see men... heavier men are more
likely to have metabolic syndrome or insulin resistance. And guess what? Men
are more likely to have a positive calcium score. All of these things just
go hand in hand. Insulin resistance, positive calcium
score, increased weight, increased obesity, aging. That's why they call it
metabolic syndrome. As we get into our 60s, 20% of men have it, starts to come
down a little bit. Anybody has any questions - why that might be the case?
Some of that may be due to how common is high triglyceride. Also, it
depends on the ethnicity. Again, with the cut-points that this group is using,
they're seeing a prevalence or a common factor of 30 percent in non-Hispanic
whites, 30 percent in non-Hispanic blacks, down to about 15
to 20 percent in Mexican-Americans over 35%. So again, you see some very
interesting variations with it. There's substantial risk once you start getting
into the standards of medicine. They start looking... we start looking at the
risks associated with triglycerides. And yes, there's significant risks associated
with elevated triglycerides even if you're able... even if you don't have
significant LDL levels. Again that that's where the standards are going is. You
know from watching this chart, I don't get that focused on LDL levels anyway.
Half the people that have a heart attack, stroke have normal LDL. But in the
standards of medicine, they still tend to be focused a little bit too much on LDL.
Now I will focus on triglycerides. One thing I haven't covered yet in this
short video is treatments. As you will hear multiple times through this series,
there's a big considered to be breakthrough treatment. It was discussed
in a New England Journal article in January of 2019. Icosapent ethyl. It's a
big new drug. It's supposed to be a blockbuster. But the reality is it's sort
of like bionic or souped-up fish oil DHA and EPA, and we can get fish oil in
our diet. You can't get it as a souped-up and bionic icosapent ethyl, but you
don't have to pay as much for that either. One of the things that this all
of this tends to avoid and forget and neglect is the vast majority of us that
have high triglycerides can impact that by impacting our insulin resistance,
cutting the carbs in our diet. If you've made it this far, thank you for your
interest. Hello my name is Ford Brewer. I started my career over three decades ago
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how do I manage that. Thank you.