Causes and Risk Factors of High Triglycerides

Causes of high triglycerides (hypertriglyceridemia) include inactivity, foods high in fat and sugar, smoking, drinking too much alcohol, and being overweight. Non-modifiable risk factors include family history, menopause, and chronic conditions like thyroid, kidney, or liver disease.

Triglycerides are a type of lipid (fat) found in the blood that, when elevated, increases the risk of heart disease, stroke, and pancreatitis. By identifying the causes of high triglycerides that you can influence, you can takes steps to reduce your risk.

This article explains what hyperglyceridemia is and lists the the various causes and risk factors, including lifestyle, genetics, medications, and medical conditions.

Definitions

Triglycerides are lipids or fats. They are, in part, what helps you sustain energy throughout the day. Your body makes triglycerides from unused calories, stores them, and releases them from fat cells into the blood when they are needed. They may also freely circulate in the bloodstream when introduced.

Levels are measured in milligram per deciliter (mg/dL). The American Heart Association notes the following designations:

Lifestyle Risk Factors

Lifestyle choices such as what you eat play a major role in maintaining normal triglyceride levels. These choices are often the main causes of increased levels.

Diet

The type of food you eat affects your triglyceride levels. Two highly influential types of foods are carbohydrates and fats.

• Carbohydrates: Experts have found that carbohydrates with a lower glycemic index (fruits, vegetables, and whole grains) reduce your triglyceride levels, while high glycemic index carbohydrates (donuts, French fries, foods with added sugar) raise your triglyceride levels.
• Fats: Interestingly, the impact of dietary fat intake on triglycerides is not completely clear. That isn't a green light to eat all the fat you want, however. Foods high in saturated fats and trans fats increase cholesterol (also a lipid), and we know that high cholesterol leads to cardiovascular disease.

A lipid-lowering diet consisting of plenty of fruits, vegetables, lean proteins, and complex carbohydrates can help keep your triglyceride levels in check. In terms of foods to avoid when working to manage triglyceride levels, cut out or minimize your consumption of highly processed products, deep-fried foods, and high-calorie fats and carbohydrates.

Smoking Cigarettes

Smoking has a complex effect on triglycerides. It may cause insulin resistance, a condition in which your body doesn't respond to insulin. While insulin is more closely associated with glucose metabolism, it also helps break down triglycerides. Therefore if insulin response is decreased, it can result in elevated levels of triglycerides.

Smoking cessation can not only lower your risk of developing high triglycerides but it can also help prevent other medical conditions, such as heart disease, emphysema, and lung cancer.

Being Overweight

Some excess calories get converted to triglycerides and then stored in fat cells. This acts as your body's reserves or energy storage it can call upon when needed. Other triglycerides circulate in the bloodstream. The more you weigh, the more your energy storage isn't tapped and the higher your triglyceride levels are likely to be.

Being overweight also alters your metabolic function, which affects how triglycerides are processed by the body.

Studies have shown that losing between 5% and 10% of your total body weight can lower your triglyceride levels by up to 20%.

Lack of Exercise

Exercise uses energy. Stored and circulating triglycerides are broken down and used for this purpose. When you don't use much energy, the triglycerides remain in the blood, leading to higher-than-normal levels.

Research shows that getting regular aerobic exercise lowers triglyceride levels. Even a moderate level of aerobic exercise, when consistent over the course of months, is enough to reduce your levels.

Sedentary Lifestyle

Physical activity helps lower your triglycerides. But a sedentary lifestyle adds to the harmful effects of not exercising and can even prevent you from getting the benefits of exercise, especially if you exercise infrequently.

A research study showed that people who normally sit for more than 13 hours per day or take fewer than 4,000 steps per day do not experience the expected decrease in triglyceride levels after doing a burst of exercise.

Drinking Too Much Alcohol

Limiting the amount of alcohol that you consume can help keep your heart—and triglyceride levels—healthy. Studies have shown that consuming alcohol can adversely affect your lipid levels in incremental amounts. It’s therefore suggested that you limit your alcohol intake to one drink per day if you are assigned female at birth, or two drinks per day if you are assigned male at birth.

Alcohol consumption affects triglyceride levels through its impact on the liver and pancreas, according to experts.

Lack of Sleep

Although a direct link between the amount one sleeps and high triglycerides has not been established, consistent lack of sleep has been linked to medical conditions that can raise triglycerides. These include high blood pressure and type 2 diabetes.

Additionally, sleep disorders such as obstructive sleep apnea have been associated with unfavorable lipid levels which would include LDL cholesterol and triglycerides. The Centers for Disease Control and Prevention (CDC) recommends a minimum of seven hours of sleep per night for most adults.

Health Conditions

Any condition that causes your body to produce more triglycerides than necessary or prevents their normal breakdown can increase the levels of this lipid in your blood.

Several medical conditions are associated with elevated lipids, including triglycerides. These illnesses may have a variety of other symptoms as well. Illnesses that cause high triglycerides include:

• Diabetes mellitus (DM): DM is characterized by elevated blood glucose. While lipid levels are not considered in the diagnostic criteria of DM, the condition is commonly associated with increases. Diabetes type l is characterized by low insulin and diabetes type ll is characterized by insulin resistance. Since insulin helps break down triglycerides, both of these conditions lead to high triglyceride levels.
• Metabolic syndrome: Metabolic syndrome is characterized by high blood pressure, excess weight, insulin resistance, and elevated lipid levels. The body fat and insulin resistance associated with this condition can lead to high triglyceride levels.
• Hypothyroidism: A deficiency in thyroid hormones interferes with the normal metabolism of lipids.
• Pregnancy: Generally, a mildly elevated triglyceride level during pregnancy is not considered dangerous, but if they’re very high, a doctor may suggest changes to your diet or medication. Hormones released during pregnancy may increase triglycerides, especially in those with gestational diabetes or obesity.
• Nephrotic syndrome: A type of kidney failure, nephrotic syndrome can interfere with the body's elimination of lipids. This condition can also increase the liver's production of lipids.
• Paraproteinemia: This condition, which is often associated with lymphoma, causes a disruption of lipid metabolism.
• (SLE)Systemic lupus erythematosus: SLE is an autoimmune disease that can affect the kidneys, gastrointestinal (GI) system, and joints. This condition can be associated with high lipids due to the involvement of the kidneys and GI system.

Genetics

Several genetic conditions can cause high levels of triglycerides, and even if you don't have one of them, you may still have an inherited tendency towards hypertriglyceridemia.

Inherited conditions that cause high triglycerides include:

• Familial combined hyperlipidemia: This is the most common type of hyperlipidemia. It is a hereditary condition that may cause high triglycerides and/or high LDL cholesterol levels.
• Dysbetalipoproteinemia: This relatively common hereditary condition is inherited in an autosomal dominant pattern. It is characterized by elevated cholesterol and triglyceride levels, which leads to premature heart disease.
• Familial hypertriglyceridemia: This is a familial condition that causes high triglyceride levels without elevated levels of cholesterol.
• Familial chylomicronemia syndrome (FCS): FCS is a rare hereditary condition that prevents the breakdown of fat. This severe disorder is associated with serious effects of elevated lipid levels, including life-threatening pancreatitis.

In addition to these genetic conditions, rare mutations affecting the genes that code for lipoprotein lipase (an enzyme that breaks down triglycerides) or apolipoprotein C2 can also cause increased triglycerides.

Medications

Certain medications can affect your lipid metabolism, resulting in high triglyceride levels. There are a number of different categories of medications associated with this side effect.

Medications that can raise triglyceride levels include:

• Steroids
• Estrogens
• Tamoxifen
• Anabolic steroids
• Non-cardioselective beta-blockers
• Thiazide diuretics
• Cyclophosphamide
• Cyclosporine
• Protease inhibitors
• Bile acid sequestrants
• Clozapine
• Atypical antipsychotics
• Antidepressants

Keep in mind that not everyone will develop high triglycerides if taking one or more of these medications. If you do experience this side effect, your healthcare provider can help by changing your dosage or exploring other medications. Do not stop taking the medication without consulting your doctor.

Summary

There are multiple risk factors that can cause an increase in triglycerides and other lipids. These include lifestyle factors, health conditions, genetics, and medications. Triglycerides can be high on their own or in combination with high cholesterol. A lipid panel blood test can help you determine your levels of triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). By working with your healthcare provider to determine the underlying cause, you can implement measures to reduce your risk of developing hypertriglyceridemia.