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Treatment of severe hypertriglyceridemia lowers plasma viscosity
1Rush-Presbyterian-St. Luke's Medical Center, Preventive Cardiology Center, Lipoprotein and Hemorheology Research Facility, Chicago, IL 60612-3833, USA.
Insights
Triglyceride-lowering therapy effectively reduced plasma viscosity in patients with severe hypertriglyceridemia. This indicates that lowering triglycerides, independent of fibrinogen levels, is crucial for managing cardiovascular risk.
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
Background:
- Elevated plasma viscosity is linked to atherosclerotic vascular disease and increased cardiovascular risk in hypertriglyceridemia.
- Previous interventions lowered both triglycerides and fibrinogen, obscuring the independent effect of triglyceride reduction on viscosity.
Purpose of the Study:
- To investigate whether triglyceride-lowering therapy alone can reduce plasma viscosity in patients with severe hypertriglyceridemia.
Main Methods:
- A prospective study involving 24 adult patients with severe hypertriglyceridemia.
- Gemfibrozil therapy (1200 mg/d) was administered.
- Measurements included fasting lipids, total serum protein, fibrinogen, plasma viscosity, and serum viscosity before and after treatment.
Main Results:
- Triglyceride levels significantly decreased by 70% (P < 0.001).
- Plasma and serum viscosity showed significant reductions (0.082 mPa/s and 0.086 mPa/s, respectively; P = 0.003 and P = 0.013).
- Fibrinogen levels remained unchanged, supporting an independent effect of triglyceride reduction.
Conclusions:
- Triglyceride-lowering therapy effectively reduces plasma and serum viscosity without altering fibrinogen levels.
- This finding provides a physiological basis for using triglyceride-lowering treatments to mitigate risks associated with atherosclerotic vascular disease, chylomicronemia syndrome, and pancreatitis.
Abstract:
Elevated plasma viscosity is a predictor of atherosclerotic vascular disease and is a potential mechanism by which hypertriglyceridemia increases cardiovascular risk. Previous studies of plasma viscosity reduction in hypertriglyceridemic patients used medications that lowered both triglyceride and fibrinogen levels. Because fibrinogen is a major determinant of viscosity, it is unclear whether triglyceride reduction alone is sufficient to reduce plasma viscosity. The purpose of this study was to determine whether triglyceride-lowering therapy reduces plasma viscosity. This was a prospective study of 24 adult patients with severe hypertriglyceridemia (> or = 5.67 mmol/l). Fasting lipid, total serum protein, fibrinogen, plasma viscosity and serum viscosity levels were measured before and after therapy with 1200 mg/d of gemfibrozil. Triglyceride levels decreased by 70% (P < 0.001). Mean plasma and serum viscosity levels decreased by 0.082 mPa/s (P = 0.003) and 0.086 mPa/s (P = 0.013), respectively. Fibrinogen levels did not change significantly. Triglyceride-lowering therapy reduced plasma and serum viscosity without changes in fibrinogen levels. Since serum samples are deplete of fibrinogen, the serum viscosity reduction observed is corroborative evidence for an independent effect of triglyceride-lowering therapy on plasma viscosity. This observation provides a physiological rationale for triglyceride-lowering therapy in patients at risk for atherosclerotic vascular disease, the chylomicronemia syndrome and pancreatitis.