Skip to main content

Advertisement

SpringerLink
Log in

Childhood Hypertriglyceridemia: Is It Time for a New Approach?

  • Children/Adolescents/Young Adults and Atherosclerosis (D.P. Wilson, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Hypertriglyceridemia (HTG) is widely prevalent in youth. There is an unmet need for effective medications in the management of HTG in youth. The purpose of this review is to summarize the approach to HTG in acute and chronic settings, and highlight emerging therapies targeted at specific genes, proteins, and enzymes to selectively alter triglyceride (TG) metabolism.

Recent Findings

Genetic and lifestyle factors play a significant role in the pathophysiology of HTG. Severe elevation of TG poses a risk of acute pancreatitis, while mild-to-moderate HTG increases the risk for premature atherosclerotic cardiovascular disease (ASCVD) and, increasingly, has been linked with non-alcoholic fatty liver disease. Although a variety of therapeutic agents are in development, strict adherence to a heart healthy lifestyle, including dietary changes, remain the cornerstone of management for youth with HTG.

In addition to lifestyle changes, pharmacological interventions, including fibrates, omega 3 fatty acids, and statins may be considered for management of moderate-to-severe HTG. In view of its association with premature cardiovascular disease (CVD), non-high-density-lipoprotein-C (non-HDL-C) is an important target for therapy in children with moderate HTG.

Summary

Management of HTG is dependent on its etiology, concomitant symptoms, and degree of TG elevation. The last two decades have seen remarkable changes in drug development, specifically those that act through the lipoprotein lipase complex, including new targeted treatments such as inhibitors of apolipoprotein C3 and angiopoietin-like protein 3.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. de Ferranti SD, Rodday AM, Mendelson MM, Wong JB, Leslie LK, Sheldrick RC. Prevalence of familial hypercholesterolemia in the 1999 to 2012 United States national health and nutrition examination surveys (NHANES). Circulation. 2016;133(11):1067–72.

    Article  CAS  PubMed  Google Scholar 

  2. •• Perak AM, Ning H, Kit BK, de Ferranti SD, Van Horn LV, Wilkins JT, et al. Trends in levels of lipids and apolipoprotein B in US youths aged 6 to 19 years, 1999–2016. JAMA. 2019;321(19):1895–905. Recent article.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Dhuper S, Sakowitz S, Daniels J, Buddhe S, Cohen HW. Association of lipid abnormalities with measures and severity of adiposity and insulin resistance among overweight children and adolescents. J Clin Hypertens (Greenwich). 2009;11(10):594–600.

    Article  CAS  Google Scholar 

  4. Korsten-Reck U, Kromeyer-Hauschild K, Korsten K, Baumstark MW, Dickhuth HH, Berg A. Frequency of secondary dyslipidemia in obese children. Vasc Health Risk Manag. 2008;4(5):1089–94.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bell LM, Curran JA, Byrne S, Roby H, Suriano K, Jones TW, et al. High incidence of obesity comorbidities in young children: a cross-sectional study. J Paediatr Child Health. 2011;47(12):911–7.

    Article  PubMed  Google Scholar 

  6. Kit BK, Carroll MD, Lacher DA, Sorlie PD, DeJesus JM, Ogden C. Trends in serum lipids among US youths aged 6 to 19 years, 1988–2010. JAMA. 2012;308(6):591–600.

    Article  CAS  PubMed  Google Scholar 

  7. •• Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128 Suppl 5(Suppl 5):S213–56. Guideline for clinical practice.

  8. Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(9):2969–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Shah AS, Wilson DP. Primary hypertriglyceridemia in children and adolescents. J Clin Lipidol. 2015;9(5 Suppl):S20–8.

    Article  PubMed  Google Scholar 

  10. Veerkamp MJ, de Graaf J, Bredie SJ, Hendriks JC, Demacker PN, Stalenhoef AF. Diagnosis of familial combined hyperlipidemia based on lipid phenotype expression in 32 families: results of a 5-year follow-up study. Arterioscler Thromb Vasc Biol. 2002;22(2):274–82.

    Article  CAS  PubMed  Google Scholar 

  11. •• 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019;290:140–205.  Guideline for clinical practice.

  12. Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. Bmj. 2012;345:e4759.

  13. •• Moulin P, Dufour R, Averna M, Arca M, Cefalù AB, Noto D, et al. Identification and diagnosis of patients with familial chylomicronaemia syndrome (FCS): expert panel recommendations and proposal of an “FCS score.” Atherosclerosis. 2018;275:265–72. Recent article.

    Article  CAS  PubMed  Google Scholar 

  14. •• Berberich AJ, Hegele RA. LDL-C cholesterol: lower, faster, younger? Lancet Diabetes Endocrinol. 2020;8(1):5–7. Recent article.

    Article  PubMed  Google Scholar 

  15. Beigneux AP, Miyashita K, Ploug M, Blom DJ, Ai M, Linton MF, et al. Autoantibodies against GPIHBP1 as a cause of hypertriglyceridemia. N Engl J Med. 2017;376(17):1647–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. •• Miyashita K, Lutz J, Hudgins LC, Toib D, Ashraf AP, Song W, et al. Chylomicronemia from GPIHBP1 autoantibodies. J Lipid Res. 2020;61(11):1365–76. Recent article.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ashraf AP, Beukelman T, Pruneta-Deloche V, Kelly DR, Garg A. Type 1 hyperlipoproteinemia and recurrent acute pancreatitis due to lipoprotein lipase antibody in a young girl with Sjögren’s syndrome. J Clin Endocrinol Metab. 2011;96(11):3302–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Fortson MR, Freedman SN, Webster PD 3rd. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134–9.

    CAS  PubMed  Google Scholar 

  19. Yadav D, Pitchumoni C. Issues in hyperlipidemic pancreatitis. J Clin Gastroenterol. 2003;36(1):54–62.

  20. •• De La Torre A, Hamilton L, Wilson DP. A clinical approach to aggressive treatment of children with severe hypertriglyceridemia. Endotext [Internet]. 2020. Recent article.

  21. Scherer J, Singh VP, Pitchumoni CS, Yadav D. Issues in hypertriglyceridemic pancreatitis: an update. J Clin Gastroenterol. 2014;48(3):195–203

  22. •• Kavey R-EW. Combined dyslipidemia in children and adolescents. Endotext [Internet]. 2020. Recent article.

  23. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes. 2001;50(8):1844–50.

    Article  CAS  PubMed  Google Scholar 

  24. Pacifico L, Chiesa C, Anania C, De Merulis A, Osborn JF, Romaggioli S, et al. Nonalcoholic fatty liver disease and the heart in children and adolescents. World J Gastroenterol. 2014;20(27):9055–71.

  25. •• Zilversmit DB. A proposal linking atherogenesis to the interaction of endothelial lipoprotein lipase with triglyceride-rich lipoproteins. Circ Res. 1973;33(6):633–8. Landmark article.

    Article  CAS  PubMed  Google Scholar 

  26. •• Qamar A, Libby P, Bhatt DL. Targeting RNA to lower triglycerides: long strides from short molecules. Eur Heart J. 2019;40(33):2797. Recent article.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Goldberg IJ, Eckel RH, McPherson R. Triglycerides and heart disease: still a hypothesis? Arterioscler Thromb Vasc Biol. 2011;31(8):1716–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. The Lancet. 2014;384(9943):626–35.

  29. •• McGill HC, Jr., McMahan CA, Zieske AW, Sloop GD, Walcott JV, Troxclair DA, et al. Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol. 2000;20(8):1998–2004. ((Landmark article))

  30. Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med. 1998;338(23):1650–6.

    Article  CAS  PubMed  Google Scholar 

  31. da Luz PL, Favarato D, Faria-Neto JR Jr, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics (Sao Paulo). 2008;63(4):427–32.

    Article  Google Scholar 

  32. Di Bonito P, Moio N, Scilla C, Cavuto L, Sibilio G, Sanguigno E, et al. Usefulness of the high triglyceride-to-HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children. Diabetes Care. 2012;35(1):158–62.

    Article  CAS  PubMed  Google Scholar 

  33. Pacifico L, Bonci E, Andreoli G, Romaggioli S, Di Miscio R, Lombardo CV, et al. Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents. Nutr Metab Cardiovasc Dis. 2014;24(7):737–43.

    Article  CAS  PubMed  Google Scholar 

  34. Morrison JA, Glueck CJ, Wang P. Childhood risk factors predict cardiovascular disease, impaired fasting glucose plus type 2 diabetes mellitus, and high blood pressure 26 years later at a mean age of 38 years: the Princeton–lipid research clinics follow-up study. Metabolism. 2012;61(4):531–41.

    Article  CAS  PubMed  Google Scholar 

  35. Swerdlow DI, Kuchenbaecker KB, Shah S, Sofat R, Holmes MV, White J, et al. Selecting instruments for Mendelian randomization in the wake of genome-wide association studies. Int J Epidemiol. 2016;45(5):1600–16.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Drenos F, Talmud PJ, Casas JP, Smeeth L, Palmen J, Humphries SE, et al. Integrated associations of genotypes with multiple blood biomarkers linked to coronary heart disease risk. Hum Mol Genet. 2009;18(12):2305–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Triglyceride Coronary Disease Genetics C, Emerging Risk Factors C, Sarwar N, Sandhu MS, Ricketts SL, Butterworth AS, et al. Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet (London, England). 2010;375(9726):1634–9.

  38. Hovingh GK, Rader DJ, Hegele RA. HDL re-examined. Curr Opin Lipidol. 2015;26(2):127–32.

    Article  CAS  PubMed  Google Scholar 

  39. Dron JS, Hegele RA. Genetics of triglycerides and the risk of atherosclerosis. Curr Atheroscler Rep. 2017;19(7):31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Khetarpal SA, Zeng X, Millar JS, Vitali C, Somasundara AVH, Zanoni P, et al. A human APOC3 missense variant and monoclonal antibody accelerate apoC-III clearance and lower triglyceride-rich lipoprotein levels. Nat Med. 2017;23(9):1086–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Cholesterol Treatment Trialists C, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376(9753):1670–81.

  42. •• Brown EE, Sturm AC, Cuchel M, Braun LT, Duell PB, Underberg JA, et al. Genetic testing in dyslipidemia: a scientific statement from the National Lipid Association. J Clin Lipidol. 2020;14(4):398-413. Recent article, clinical practice guideline.

    Article  PubMed  Google Scholar 

  43. Pongsuthana S, Tivatunsakul N. Optimal fasting time before measurement of serum triglyceride levels in healthy volunteers. J Med Assoc Thai. 2016;99(Suppl 2):S42–6.

    PubMed  Google Scholar 

  44. Driver SL, Martin SS, Gluckman TJ, Clary JM, Blumenthal RS, Stone NJ. Fasting or nonfasting lipid measurements: it depends on the question. J Am Coll Cardiol. 2016;67(10):1227–34.

  45. ••Varghese V, Griener D, Wu Q, Velez JCQ. Pseudohypobicarbonatemia in severe hypertriglyceridemia. Am J Kidney Dis. 2020;76(4):601–3. Recent article.

    Article  CAS  PubMed  Google Scholar 

  46. Ashraf AP, Hurst ACE, Garg A. Extreme hypertriglyceridemia, pseudohyponatremia, and pseudoacidosis in a neonate with lipoprotein lipase deficiency due to segmental uniparental disomy. J Clin Lipidol. 2017;11(3):757–62.

  47. •• Theis SR, Khandhar PB. Pseudohyponatremia. 2020. Recent article.

  48. Lopez-Miranda J, Williams C, Lairon D. Dietary, physiological, genetic and pathological influences on postprandial lipid metabolism. Br J Nutr. 2007;98(3):458–73.

    Article  CAS  PubMed  Google Scholar 

  49. Williams L, Rhodes KS, Karmally W, Welstead LA, Alexander L, Sutton L. Familial chylomicronemia syndrome: bringing to life dietary recommendations throughout the life span. J Clin Lipidol. 2018;12(4):908–19.

    Article  PubMed  Google Scholar 

  50. Rhodes KS, Weintraub M, Marchlewicz EH, Rubenfire M, Brook RD. Medical nutrition therapy is the essential cornerstone for effective treatment of “refractory” severe hypertriglyceridemia regardless of pharmaceutical treatment: evidence from a lipid management program. J Clin Lipidol. 2015;9(4):559–67.

    Article  PubMed  Google Scholar 

  51. Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(9):2969–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496–506.

    Article  PubMed  Google Scholar 

  53. Tsuang W, Navaneethan U, Ruiz L, Palascak JB, Gelrud A. Hypertriglyceridemic pancreatitis: presentation and management. Am J Gastroenterol. 2009;104(4):984–91.

    Article  CAS  PubMed  Google Scholar 

  54. Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet (London, England). 2010;376(9753):1670–81.

    Article  CAS  Google Scholar 

  55. Kavey RE. Combined dyslipidemia in childhood. J Clin Lipidol. 2015;9(5 Suppl):S41-56.

    Article  PubMed  Google Scholar 

  56. Hunninghake DB, Stein EA, Bays HE, Rader DJ, Chitra RR, Simonson SG, et al. Rosuvastatin improves the atherogenic and atheroprotective lipid profiles in patients with hypertriglyceridemia. Coron Artery Dis. 2004;15(2):115–23.

    Article  PubMed  Google Scholar 

  57. Bakker-Arkema RG, Davidson MH, Goldstein RJ, Davignon J, Isaacsohn JL, Weiss SR, et al. Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia. JAMA. 1996;275(2):128–33.

    Article  CAS  PubMed  Google Scholar 

  58. de Ferranti SD, Milliren CE, Denhoff ER, Steltz SK, Selamet Tierney ES, Feldman HA, et al. Using high-dose omega-3 fatty acid supplements to lower triglyceride levels in 10- to 19-year-olds. Clin Pediatr (Phila). 2014;53(5):428–38.

    Article  Google Scholar 

  59. Gidding SS, Prospero C, Hossain J, Zappalla F, Balagopal PB, Falkner B, et al. A double-blind randomized trial of fish oil to lower triglycerides and improve cardiometabolic risk in adolescents. J Pediatr. 2014;165(3):497-503.e2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Engler MM, Engler MB, Malloy M, Chiu E, Besio D, Paul S, et al. Docosahexaenoic acid restores endothelial function in children with hyperlipidemia: results from the EARLY study. Int J Clin Pharmacol Ther. 2004;42(12):672–9.

    Article  CAS  PubMed  Google Scholar 

  61. Kastelein JJ, Maki KC, Susekov A, Ezhov M, Nordestgaard BG, Machielse BN, et al. Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: the EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial. J Clin Lipidol. 2014;8(1):94–106.

    Article  PubMed  Google Scholar 

  62. Harris WS, Ginsberg HN, Arunakul N, Shachter NS, Windsor SL, Adams M, et al. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk. 1997;4(5–6):385–91.

  63. Pownall HJ, Brauchi D, Kilinc C, Osmundsen K, Pao Q, Payton-Ross C, et al. Correlation of serum triglyceride and its reduction by omega-3 fatty acids with lipid transfer activity and the neutral lipid compositions of high-density and low-density lipoproteins. Atherosclerosis. 1999;143(2):285–97.

  64. Bays HE, Ballantyne CM, Kastelein JJ, Isaacsohn JL, Braeckman RA, Soni PN. Eicosapentaenoic acid ethyl ester (AMR101) therapy in patients with very high triglyceride levels (from the Multi-center, plAcebo-controlled, Randomized, double-blINd, 12-week study with an open-label Extension [MARINE] trial). Am J Cardiol. 2011;108(5):682–90.

    Article  CAS  PubMed  Google Scholar 

  65. •• Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2019;380(1):11–22. Recent article.

    Article  CAS  PubMed  Google Scholar 

  66. •• Nicholls SJ, Lincoff AM, Garcia M, Bash D, Ballantyne CM, Barter PJ, et al. Effect of high-dose omega-3 fatty acids vs corn oil on major adverse cardiovascular events in patients at high cardiovascular risk: the STRENGTH randomized clinical trial. JAMA. 2020;324(22):2268–80. Recent article.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. •• De Ferranti SD, Steinberger J, Ameduri R, Baker A, Gooding H, Kelly AS, et al. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association. Circulation. 2019;139(13):e603–34. Recent article and clinical guideline.

    Article  PubMed  Google Scholar 

  68. Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. 2012;97(9):2969–89.

    CAS  Google Scholar 

  69. Abourbih S, Filion KB, Joseph L, Schiffrin EL, Rinfret S, Poirier P, et al. Effect of fibrates on lipid profiles and cardiovascular outcomes: a systematic review. Am J Med. 2009;122(10):962.e1-8.

    Article  CAS  Google Scholar 

  70. Guérin M, Bruckert Er, Dolphin PJ, Turpin Gr, Chapman MJ. Fenofibrate reduces plasma cholesteryl ester transfer from HDL to VLDL and normalizes the atherogenic, dense LDL profile in combined hyperlipidemia. Arteriosclerosis, thrombosis, and vascular biology. 1996;16(6):763–72.

  71. Wheeler KA, West RJ, Lloyd JK, Barley J. Double blind trial of bezafibrate in familial hypercholesterolaemia. Arch Dis Child. 1985;60(1):34–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Steinmetz J, Morin C, Panek E, Siest G, Drouin P. Biological variations in hyperlipidemic children and adolescents treated with fenofibrate. Clin Chim Acta. 1981;112(1):43–53.

    Article  PubMed  Google Scholar 

  73. Becker M, Staab D, Von Bergman K. Long-term treatment of severe familial hypercholesterolemia in children: effect of sitosterol and bezafibrate. Pediatrics. 1992;89(1):138–42.

    Article  CAS  PubMed  Google Scholar 

  74. Smalley CM, Goldberg SJ. A pilot study in the efficacy and safety of gemfibrozil in a pediatric population. J Clin Lipidol. 2008;2(2):106–11.

    Article  PubMed  Google Scholar 

  75. Yeh JH, Lee MF, Chiu HC. Plasmapheresis for severe lipemia: comparison of serum-lipid clearance rates for the plasma-exchange and double-filtration variants. J Clin Apher. 2003;18(1):32–6.

  76. Gaudet D, Brisson D, Tremblay K, Alexander VJ, Singleton W, Hughes SG, et al. Targeting APOC3 in the familial chylomicronemia syndrome. N Engl J Med. 2014;371(23):2200–6.

    Article  CAS  PubMed  Google Scholar 

  77. Gaudet D, Alexander VJ, Baker BF, Brisson D, Tremblay K, Singleton W, et al. Antisense inhibition of apolipoprotein C-III in patients with hypertriglyceridemia. N Engl J Med. 2015;373(5):438–47.

  78. Gaudet D, Digenio A, Alexander V, Arca M, Jones A, Stroes E, et al. The APPROACH study: a randomized, double-blind, placebo-controlled, phase 3 study of volanesorsen administered subcutaneously to patients with familial chylomicronemia syndrome (FCS). Atherosclerosis. 2017;263:e10.

  79. •• Witztum JL, Gaudet D, Freedman SD, Alexander VJ, Digenio A, Williams KR, et al. Volanesorsen and triglyceride levels in familial Chylomicronemia syndrome. N Engl J Med. 2019;381(6):531–42. Recent article.

    Article  CAS  PubMed  Google Scholar 

  80. Gouni-Berthold I, Alexander V, Digenio A, Dufour R, Steinhagen-Thiessen E, Martin S, et al., editors. Apolipoprotein C-III inhibition with volanesorsen in patients with hypertriglyceridemia (COMPASS): a randomized, double-blind, pbo-controlled trial. Clinical cardiology; 2017: WILEY 111 River st, Hoboken 07030–5774, NJ USA.

  81. •• Esan O, Wierzbicki AS. Volanesorsen in the treatment of familial Chylomicronemia syndrome or hypertriglyceridaemia: design, development and place in therapy. Drug Des Dev Ther. 2020;14:2623. Recent article.

    Article  CAS  Google Scholar 

  82. •• Alexander VJ, Xia S, Hurh E, Hughes SG, O’Dea L, Geary RS, et al. N-acetyl galactosamineconjugated antisense drug to APOC3 mRNA, triglycerides and atherogenic lipoprotein levels. Eur Heart J. 2019;40(33):2785–96. Recent article.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. •• Alexander Veronica J, Digenio A, Xia S, Hurh E, Hughes S, Geary Richard S, et al. Inhibition of apolipoprotein C-III with GalNac conjugated antisense drug potently lowers Fasting serum apolipoprotein C-III and triglyceride levels in healthy volunteers with elevated triglycerides. J Am Coll Cardiol. 2018;71(11_Supplement):A1724-A. Recent article.

  84. •• Ahmad Z, Banerjee P, Hamon S, Chan KC, Bouzelmat A, Sasiela WJ, et al. Inhibition of angiopoietin-like protein 3 with a monoclonal antibody reduces triglycerides in hypertriglyceridemia. Circulation. 2019;140(6):470–86. Recent article.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. •• Raal FJ, Rosenson RS, Reeskamp LF, Hovingh GK, Kastelein JJP, Rubba P, et al. Evinacumab for homozygous familial hypercholesterolemia. N Engl J Med. 2020;383(8):711–20. Recent article.

    Article  CAS  PubMed  Google Scholar 

  86. •• Markham A. Evinacumab: first approval. Drugs. 2021:1–5. Recent article.

  87. Nordestgaard BG. Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease: new insights from epidemiology, genetics, and biology. Circ Res. 2016;118(4):547–63.

    Article  CAS  PubMed  Google Scholar 

  88. •• Ben-Omran T, Masana L, Kolovou G, Ariceta G, Nóvoa FJ, Lund AM, et al. Real-world outcomes with lomitapide use in paediatric patients with homozygous familial hypercholesterolaemia. Adv Ther. 2019;36(7):1786–811. Recent article.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Mary Bridge Children’s Hospital, Tacoma, WA, USA

    Bhuvana Sunil

  2. Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University of Alabama at Birmingham, 1600 4th Ave S CPP, Suite M30, Birmingham, AL, 35233, USA

    Ambika P. Ashraf

Authors
  1. Bhuvana Sunil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ambika P. Ashraf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ambika P. Ashraf.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Children/Adolescents/Young Adults and Atherosclerosis

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sunil, B., Ashraf, A.P. Childhood Hypertriglyceridemia: Is It Time for a New Approach?. Curr Atheroscler Rep 24, 265–275 (2022). https://doi.org/10.1007/s11883-022-01000-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11883-022-01000-2

Keywords

Search

Navigation