Triglycerides: What do elevated levels mean?

What are triglycerides?

Triglycerides, also known as neutral fats, are blood lipids, just like cholesterol. They are important energy stores in the body. Triglycerides are absorbed from food. However, the body can also produce them itself, particularly in the liver. Excess carbohydrates can be converted into fat in this process. Alcohol can also promote the formation of triglycerides. Triglycerides supply the body with energy. Any triglycerides that the body does not currently need are stored in adipose tissue. Several kilograms of triglycerides can be stored in an adult’s adipose tissue. When energy is required, they can be released from the adipose tissue and used to produce energy. Triglycerides consist of a glycerol molecule linked to three fatty acids. In the blood, they are bound to specific transport molecules. These so-called lipoproteins transport the triglycerides throughout the body. Triglycerides are broken down by specific enzymes, known as lipases. These enzymes break down the triglycerides into glycerol and fatty acids. The glycerol is then released into the blood.

Why can elevated triglyceride levels be problematic?

Triglycerides are very important energy stores. However, if their levels remain persistently high, the risk of cardiovascular disease may increase. A combination of high triglycerides and high cholesterol – particularly LDL cholesterol – is particularly unfavourable. This combination can promote the development of atherosclerosis and, consequently, conditions such as heart attack or stroke. Fasting triglyceride levels are generally considered high from around 150 mg/dl (1.7 mmol/l). However, how a value is medically assessed depends on the individual’s overall risk profile. Very high triglyceride levels are particularly significant: as levels rise, so does the risk of acute inflammation of the pancreas (pancreatitis). This risk is particularly pronounced at very high levels. Severe or recurrent pancreatitis, in turn, can impair the function of the pancreas and increase the risk of subsequently developing diabetes mellitus. It is therefore important to take elevated triglyceride levels seriously and to have the cause investigated by a doctor. Depending on the cause and the level of the values, treatment may be advisable to bring them back to normal.

Reference values: What are normal triglyceride levels?

A blood sample is required to measure blood lipid levels. Patients should fast before the blood test to ensure the results are accurate. As a guide, a fasting level of less than 150 mg/dl is considered favourable for adults with a low cardiovascular risk. A laboratory result outside the reference range does not necessarily mean that a disease is present. Even in healthy people, the levels may deviate slightly from the reference range. The reference ranges provided by the respective laboratory are therefore always decisive when assessing a laboratory result. Individual factors must also be taken into account. These include, for example, age, existing medical conditions and other laboratory results. Laboratory results should be interpreted in consultation with a doctor, such as a general practitioner. If necessary, or if a medical condition is suspected, further investigations can be arranged. You should also seek medical advice if you have any questions about a laboratory result or if you suspect you may have a medical condition.

What causes elevated triglyceride levels?

Elevated triglyceride levels can have various causes. These include, amongst others:

• lipid metabolism disorders
• an unbalanced diet high in fat and sugar
• Lack of exercise
• excessive alcohol consumption
• Overweight (obesity)
• Diabetes mellitus
• chronic kidney dysfunction
• Pregnancy
• taking certain medicines

A congenital lipid metabolism disorder can also lead to elevated triglyceride levels. In this case, the condition is referred to as primary hypertriglyceridaemia. If the elevated levels are caused by another medical condition or by certain other factors, the condition is referred to as secondary or acquired hypertriglyceridaemia.

What can be done about high triglyceride levels?

What can be done to address elevated triglyceride levels depends on the cause and the severity of the condition. In some cases, the levels can be reduced simply by making lifestyle changes. The following are particularly important:

• losing weight, if you are overweight
• a balanced, fibre-rich diet including vegetables, pulses and wholemeal products
• Significantly limiting sugar and sugary foods and drinks
• getting enough exercise
• reducing alcohol consumption or avoiding alcohol altogether

As a general rule, a balanced diet, sufficient exercise and limited alcohol consumption can have a beneficial effect on triglyceride levels. Conversely, a diet high in fat and sugar, little exercise and high alcohol consumption can raise these levels. If lifestyle changes are not sufficient, or if triglyceride levels are significantly elevated, medication may also be used. The appropriate treatment depends on the overall risk profile. Where there is an increased cardiovascular risk, for example, statins play an important role. Where triglyceride levels are very high, other medicines may also be used to specifically lower these levels. In summary: less fat and sugar, less animal fat and fewer highly processed foods. Instead, opt for more plant-based foods, a high-fibre diet and meals prepared as fresh as possible.