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RESUMEN Introducción: La hipertrigliceridemia se ha vinculado con la resistencia a la insulina. Objetivos: Evaluar la relación y capacidad predictiva de la hipertrigliceridemia para la resistencia a la insulina en niños obesos. Métodos: Se realizó un estudio transversal y analítico en niños de 6 a 14 años con obesidad, atendidos en el Hospital Belén de Trujillo entre 2014 y 2019. Se analizaron 58 historias clínicas elegidas aleatoriamente. La resistencia a la insulina se midió mediante el índice Homeostasis Model Assessment (HOMA) (≥3). Se usaron análisis descriptivos, correlacionales y cálculos de Odds Ratio (OR), además de indicadores de predicción como sensibilidad y especificidad. Resultados: De los 58 niños estudiados, el 58,6% presentaba niveles elevados de triglicéridos y el 74,1% mostró resistencia a la insulina. Hubo una correlación significativa entre los niveles de triglicéridos y el índice HOMA (coef.: 0,543; p<0,001). Los niveles elevados de triglicéridos (OR=18,91; IC 95%: 3,67-97,36; p<0,001), glicemia en ayunas (OR=46,20; IC 95%: 5,39-396,06; p=0,010), de insulina en ayunas (OR=52,89; IC 95%: 6,11-457,55; p<0,001) y la presencia de acantosis nigricans (OR=36,17; IC 95%: 4,28-305,98; p<0,001) se asociaron significativamente con la resistencia a la insulina. La hipertrigliceridemia mostró una sensibilidad del 74,4% y una especificidad del 86,7% para predecir la resistencia a la insulina. Conclusión: La hipertrigliceridemia está significativamente asociada con la resistencia a la insulina en niños obesos y tiene un rendimiento aceptable como predictor de la misma. Este factor puede servir como un marcador temprano y predictor para implementar medidas preventivas adecuadas en poblaciones vulnerables.

ABSTRACT Introduction: Hypertriglyceridemia has been linked to insulin resistance. Objectives: To evaluate the relationship and predictive capacity of hypertriglyceridemia for insulin resistance in obese children. Methods: A cross-sectional analytical study was conducted in obese children aged 6 to 14 years, treated at the Belén Hospital of Trujillo between 2014 and 2019. Fifty-eight randomly selected medical records were analyzed. Insulin resistance was measured using the Homeostasis Model Assessment (HOMA) index (≥3). Descriptive, correlational analyses, and Odds Ratio (OR) calculations were used, along with predictive indicators such as sensitivity and specificity. Results: Of the 58 children studied, 58.6% had elevated triglyceride levels and 74.1% showed insulin resistance. There was a significant correlation between triglyceride levels and the HOMA index (coef.: 0.543; p<0.001). Elevated triglyceride levels (OR=18.91; 95% CI: 3.67-97.36; p<0.001), fasting glucose (OR=46.20; 95% CI: 5.39-396.06; p=0.010), fasting insulin (OR=52.89; 95% CI: 6.11-457.55; p<0.001), and the presence of acanthosis nigricans (OR=36.17; 95% CI: 4.28-305.98; p<0.001) were significantly associated with insulin resistance. Hypertriglyceridemia showed a sensitivity of 74.4% and a specificity of 86.7% for predicting insulin resistance. Conclusion: Hypertriglyceridemia is significantly associated with insulin resistance in obese children and has an acceptable performance as a predictor. This factor may serve as an early marker and predictor to implement appropriate preventive measures in vulnerable populations.

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ABSTRACT In order to evaluate the effect of total parenteral nutrition associated with glutamine and enteral fluid therapy, associated or not with glutamine, on the lipidogram of horses subjected to starvation (phase 1) and refeeding (phase 2), 16 adult healthy horses were used, mixed breed, aged between four and fourteen years and average weight of 248.40 ± 2.28kg, divided into four experimental groups, with four animals per group: Group ENTGL: enteral fluid therapy with electrolytes associated with glutamine; Group PARGL: total parenteral nutrition associated with glutamine; Group ENTFL: enteral fluid therapy with electrolytes; and Group PARFL: parenteral fluid therapy. This study was divided into two phases: phase 1 and phase 2. Phase 1 consisted of performing exploratory laparotomy and beginning of starvation, in addition to the administration of treatments, according to the group, while phase 2 consisted of re-feeding the animals. Total cholesterol values remained within the normal range for the species throughout the experimental period, but there was a slight increase during phase 1, followed by a decrease in values in phase 2. Hypertriglyceridemia in the ENFL, ENTGL and PARFL groups during phase 1 occurred because of the negative energy balance. The provision of enteral fluid therapy with electrolytes and an energy source, with or without glutamine, or parenteral fluid therapy were not effective in reversing the effects of negative energy balance. Thus, therapeutic protocols that combine enteral or parenteral fluid therapy for prolonged periods and food deprivation need additional nutritional support to avoid the deleterious effects of negative energy balance.

RESUMO Com o objetivo de avaliar o efeito da nutrição parenteral total associada à glutamina e da fluidoterapia enteral, associada ou não à glutamina, sobre o lipidograma de equinos submetidos à inanição (fase 1) e realimentação (fase 2), foram utilizados 16 equinos adultos hígidos, sem raça definida, com idade variando entre quatro e 14 anos e peso médio de 248,40 ± 2,28kg, divididos em quatro grupos experimentais, quatro animais por grupo: grupo ENTGL: fluidoterapia enteral com eletrólitos associada à glutamina; grupo II PARGL: nutrição parenteral total associada à glutamina; grupo ENTFL: fluidoterapia enteral com eletrólitos; e grupo PARFL: fluidoterapia parenteral. Este estudo foi dividido em duas fases: fase 1 e fase 2. A fase 1 consistiu na realização da laparotomia exploratória e no início da inanição, além da administração dos tratamentos, de acordo com o grupo; a fase 2 consistiu na realimentação dos animais. Os valores de colesterol total se mantiveram dentro da faixa de normalidade para a espécie durante todo o período experimental, porém houve discreta elevação ao longo da fase 1, seguida de diminuição dos valores na fase 2. Hipertrigliceridemia nos grupos ENTFL, ENTGL e PARFL durante a fase 1 ocorreu em decorrência do equilíbrio energético negativo. O fornecimento de fluidoterapia enteral com eletrólitos e uma fonte de energia, associada ou não à glutamina, ou o de fluidoterapia parenteral não foram efetivos em reverter os efeitos do equilíbrio energético negativo. Dessa forma, protocolos terapêuticos que associem fluidoterapia enteral ou parenteral por períodos prolongados e privação alimentar necessitam de suporte nutricional adicional para evitar os efeitos deletérios do equilíbrio energético negativo

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Antecedentes: Las enfermedades no transmisibles siguen siendo un problema creciente en el mundo, sobre todo en los países de mediano y bajo ingresos. Los programas de intervención comunitaria se enfocan en su disminución mediante cambios en estilos de vida más saludables. Objetivos: Analizar la tendencia del programa de intervención en actividad física y nutrición, como estrategia para mejorar las dislipidemias y glucemia en los participantes del proyecto DemoMinga. Materiales y métodos: Estudio con enfoque cuantitativo. Diseño de investigación acción participativa, de carácter longitudinal, prospectivo. La población estuvo constituida por los participantes del Proyecto DemoMinga. Se determinó en cada participante: colesterol total, triglicéridos y glucemia en ayunas. Las muestras fueron procesadas en el Centro de Investigaciones Médicas de la FACISA-UNE. Se determinaron indicadores de tendencia central (mediana) de cada una de las variables. Resultados: Hubo mayor participación del sexo femenino, con predominio de personas con menos de 45 años. Las mediciones químicas arrojaron una tendencia de disminución a partir del quinto año de intervención, con talleres de cocina saludable incluyendo uso de aceite alto oleico, y actividad física. Sin embargo, la prueba no arrojó diferencias significativas de las mediciones entre la línea de base y el corte a los 6 años. Conclusión: El estudio resalta la importancia de los programas de intervención mediante terapias integrales para la promoción y prevención de las enfermedades cardiometabólicas a largo plazo.

Background: Non-communicable diseases remain a growing problem worldwide, especially in middle and low-income countries. Community intervention programs are focused on reducing their prevalence through promoting healthier lifestyle changes. Objectives: To analyze the trend of the physical activity and nutrition intervention program as a strategy to improve dyslipidemia and glycemia among participants of the DemoMinga project. Materials and methods: This study employed a quantitative approach with a participatory action research design, characterized as longitudinal and prospective. The population consisted of participants from the DemoMinga Project. For each participant, total cholesterol, triglycerides, and fasting glycemia were measured. Samples were processed at the Medical Research Center of FACISA-UNE. Indicators of central tendency (median) were determined for each of the variables. Results: There was a higher participation of females, with a predominance of individuals under the age of 45. Chemical measurements showed a decreasing trend starting from the fifth year of intervention, involving healthy cooking workshops that included the use of high oleic oil and physical activity. However, the test did not yield significant differences in measurements between the baseline and the 6-year cutoff. Conclusion: The study highlights the significance of intervention programs using comprehensive therapies for the long-term promotion and prevention of cardiometabolic diseases.

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Antecedentes: Las enfermedades no transmisibles siguen siendo un problema creciente en el mundo, sobre todo en los países de mediano y bajo ingresos. Los programas de intervención comunitaria se enfocan en su disminución mediante cambios en estilos de vida más saludables. Objetivos: Analizar la tendencia del programa de intervención en actividad física y nutrición, como estrategia para mejorar las dislipidemias y glucemia en los participantes del proyecto DemoMinga. Materiales y métodos: Estudio con enfoque cuantitativo. Diseño de investigación acción participativa, de carácter longitudinal, prospectivo. La población estuvo constituida por los participantes del Proyecto DemoMinga. Se determinó en cada participante: colesterol total, triglicéridos y glucemia en ayunas. Las muestras fueron procesadas en el Centro de Investigaciones Médicas de la FACISA-UNE. Se determinaron indicadores de tendencia central (mediana) de cada una de las variables. Resultados: Hubo mayor participación del sexo femenino, con predominio de personas con menos de 45 años. Las mediciones químicas arrojaron una tendencia de disminución a partir del quinto año de intervención, con talleres de cocina saludable incluyendo uso de aceite alto oleico, y actividad física. Sin embargo, la prueba no arrojó diferencias significativas de las mediciones entre la línea de base y el corte a los 6 años. Conclusión: El estudio resalta la importancia de los programas de intervención mediante terapias integrales para la promoción y prevención de las enfermedades cardiometabólicas a largo plazo.

Background: Non-communicable diseases remain a growing problem worldwide, especially in middle and low-income countries. Community intervention programs are focused on reducing their prevalence through promoting healthier lifestyle changes. Objectives: To analyze the trend of the physical activity and nutrition intervention program as a strategy to improve dyslipidemia and glycemia among participants of the DemoMinga project. Materials and methods: This study employed a quantitative approach with a participatory action research design, characterized as longitudinal and prospective. The population consisted of participants from the DemoMinga Project. For each participant, total cholesterol, triglycerides, and fasting glycemia were measured. Samples were processed at the Medical Research Center of FACISA-UNE. Indicators of central tendency (median) were determined for each of the variables. Results: There was a higher participation of females, with a predominance of individuals under the age of 45. Chemical measurements showed a decreasing trend starting from the fifth year of intervention, involving healthy cooking workshops that included the use of high oleic oil and physical activity. However, the test did not yield significant differences in measurements between the baseline and the 6-year cutoff. Conclusion: The study highlights the significance of intervention programs using comprehensive therapies for the long-term promotion and prevention of cardiometabolic diseases.

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RESUMEN Introducción : La hipertrigliceridemia grave (HTGG) es un desorden metabólico con múltiples causas e implicancias tera péuticas. Se desconocen hasta la fecha las características clínicas, la prevalencia y sus posibles causas en nuestra población. Objetivo : estimar la prevalencia, describir las características clínicas y causas subyacentes de la HTGG en un hospital de tercer nivel del municipio de General Pueyrredón. Materia y métodos : Estudio descriptivo y observacional realizado con pacientes ambulatorios e internados de un hospital provincial. Se incluyeron pacientes adultos con triglicéridos (TG) mayores que 885 mg/dL (10 mmol/L) evaluados desde enero de 2018 a diciembre de 2021. Se extrajeron sus historias clínicas y, luego, se los contactó para obtener medidas antro pométricas, variables sociodemográficas, antecedentes personales y familiares, causas secundarias de hipertrigliceridemia y el tratamiento recibido. Resultados : Se analizaron 16 029 muestras; 46 presentaron HTGG, lo que representa una prevalencia total del 0,28% (IC 95% 0,20-0,40%) (IC 95% 0,20-0,40%); se incluyeron 19 participantes en el análisis. La edad media fue de 48,47 años (DE ±16); el 84,2% de ellos eran hombres. La mediana de triglicéridos fue 1821 mg/dL (rango intercuartílico 917-7000 mg/dL); 17 participantes (84,97%) presentaban hipercolesterolemia (colesterol total mayor que 200 mg/dL). Casi el 50% refirió consumo de alcohol, el 55% presentaba obesidad y el 68% diabetes tipo II. Solo 9 participantes se encontraban en tratamiento, 4 con fibratos y 5 con estatinas. Conclusión : se encontró una prevalencia del 0,28%, más alta que la esperada y reportada en series previas. Por otro lado, se destaca la subutilización de medicación para el tratamiento de esta dislipidemia grave.

ABSTRACT Background : Severe hypertriglyceridemia (SHTG) is a metabolic disorder with multiple origins and management implications. Prevalence, clinical characteristics, and its possible causes are unknown in Argentina. Objective : The aim of this study was to estimate the prevalence and describe the clinical characteristics and underlying SHTG causes in a third level hospital in the municipality of General Pueyrredón. Methods : An observational, descriptive study was performed using an electronic database from a provincial Hospital. It included adult patients with triglyceride (TG) levels above 885 mg/dL (10 mmol/L) evaluated from January 2018 to December 2021. Medical records were collected, and patients were then contacted to obtain anthropometric measurements, sociodemographic variables, personal and family history, secondary causes of hypertriglyceridemia, and treatment received. Results : Among 16 029 patients analyzed, 46 presented SHTG, representing a total prevalence of 0.28% (95% CI 0.20-0.40%). Finally, 19 participants with mean age 48.47±16 years and 84.2% men were included in the analysis. Median TG level was 1821 mg/dL (interquartile range 917-7000 mg/dL), and 17 participants (84.97%) had hypercholesterolemia (total cholesterol >200 mg/dL). Almost 50% reported alcohol consumption, 55% were obese and 68% had type II diabetes. Nine participants were under pharmacological treatment, 4 with fibrates and 5 with statins. Conclusion : A prevalence of 0.28% SHTG was found, higher than that reported in other series. Another finding was the underuse of medication for this severe dyslipidemia.

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BACKGROUND AND AIMS: Triglycerides are the initiators of the metabolic changes that lead to atherogenic dyslipidemia (AD). The APOA5 and APOA1 genes are involved in the response and metabolism of serum lipids and lipoproteins, where single nucleotide polymorphisms (SNP) rs662799 (promoter region) and rs5070 (intronic region) have been associated with the susceptibility to dyslipidemia. Until now, few studies evaluate the association of these polymorphisms with the presentation of hypertriglyceridemia and AD among Mexican children. Therefore, the objective was to determine the association between rs662799 and rs5070 with hypertriglyceridemia and AD in a pediatric population of southeastern Mexico. MATERIALS AND METHODS: A case-control analysis was performed including 268 infants aged 2-16 years, anthropometric, clinical variables, and serum lipid profiles were analyzed. DNA was extracted from blood samples and genotyping of polymorphisms was executed with the TaqMan SNP genotyping assay. Allele and genotypic frequencies were calculated. For genetic association analysis, logistic regression models were fitted according to models of inheritance. RESULTS: The SNP rs662799 (C) was significantly associated with hypertriglyceridemia in the overdominant model (OR=3.89, p=0.001) and AD in the dominant model (OR=4.01, p=0.001). The SNP rs5070 (T) has a protective effect against hypertriglyceridemia in the additive risk model (OR=0.68, p=0.03). CONCLUSION: Polymorphism rs662799 was significantly associated with cases of hypertriglyceridemia and AD in minors in southeastern Mexico. On the other hand, rs5070 polymorphism was not associated with cases of hypertriglyceridemia or AD.

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La hipertrigliceridemia severa es una de las principales causas etiológicas de la pancreatitis aguda, donde la literatura internacional la posiciona como la tercera causa. Sus causas gatillantes, comorbilidades, severidad y evolución son importantes de conocer para evitar futuros episodios. En Chile, a nuestro entender, no tenemos literatura sobre esta asociación, por lo que presentamos datos de un hospital terciario, destacando 15 casos de pancreatitis aguda en 5 años de estudio, casi la mitad de ellos con antecedentes previos de hipertrigliceridemia, un porcentaje importante de los casos con cuadros graves y con complicaciones intrahospitalarias y que la diabetes mellitus tipo 2 fue la principal condición asociada a la hipertrigliceridemia severa.

Severe hypertriglyceridaemia is one of the main aetiological causes of acute pancreatitis, with international literature ranking it as the third leading cause. Its triggering causes, comorbidities, severity and evolution are important to know in order to avoid future episodes. In Chile, to our knowledge, we have no literature on this association, so we present data from a tertiary hospital, highlighting 15 cases of acute pancreatitis in 5 years of study, almost half of them with a previous history of hypertriglyceridaemia, a significant percentage of cases with severe symptoms and in-hospital complications, and that type 2 diabetes mellitus was the main condition associated with severe hypertriglyceridaemia.

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Introducción : El Síndrome Metabólico (SM) es una entidad clínica que se manifiesta por obesidad central, dislipidemia, hiperglicemia y/o hipertensión arterial y se relaciona con el desarrollo de Diabetes Mellitus tipo 2 y enfermedades cardiovasculares. Objetivo : Determinar la prevalencia del SM en adolescentes escolarizados del Departamento Central en el 2021 y evaluar los factores de riesgo relacionados. Materiales y Métodos: Estudio descriptivo con componente analítico. Ingresaron 279 adolescentes de 10 a 16 años de 6 escuelas elegidas aleatoriamente. Se realizó una encuesta sobre estilos de vida, prácticas alimentarias, antecedentes familiares y perinatales. Se realizó medición de peso, talla, circunferencia de cintura (CC), glicemia, perfil lipídico y presión arterial. Para el diagnóstico de SM se utilizó los criterios de Cook. Aprobado por el Comité de Ética del IICS y del Hospital de Clínicas. Para el análisis se utilizaron tablas de frecuencias, mediana y Prueba del Chi cuadrado para razón de prevalencias (RP) con nivel de significancia p p90 36%. La prevalencia de SM fue del 10,7 %. La CC >p90 con RP de 31,4 (7,6-128), y la hipertrigliceridemia con RP de 46,8(14,8-147,7), fueron los componentes preponderantes de SM. El peso elevado al nacer y no realizar actividad física, fueron identificados como factores de riesgo significativo. Conclusiones: La prevalencia de SM fue 10,7%, se relacionó con mayor peso al nacimiento, obesidad y sedentarismo.

Introduction: Metabolic Syndrome (MS) is a clinical entity that is manifested by central obesity, dyslipidemia, hyperglycemia and/or arterial hypertension and is related to the development of Type 2 Diabetes Mellitus and cardiovascular diseases. Objective: To determine the prevalence of MS in adolescents enrolled in school in the Central Department in 2021 and to evaluate their related risk factors. Materials and Methods: This was a descriptive study with an analytical component. 279 adolescents aged 10 to 16 years old from 6 randomly chosen schools were included. A survey on lifestyles, eating practices, family and perinatal history was performed. Weight, height, waist circumference (WC), glycemia, lipid profile, and blood pressure were measured. Cook's criteria were used for the diagnosis of MS. The study was approved by the Ethics Committee of the IICS and the University Hospital. For data analysis, tables of frequencies, median and Chi-square test were used for the prevalence ratio (PR) with a significance level of p p90 in 36%. The prevalence of MS was 10.7%. WC >p90 with a PR of 31.4 (7.6-128), and hypertriglyceridemia with a PR of 46.8 (14.8-147.7), were the predominant components of MS. High birth weight and physical inactivity were identified as significant risk factors. Conclusions: The prevalence of MS was 10.7%, it was related to higher birth weight, obesity and sedentary lifestyle.

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Familial chylomicronemia syndrome (FCS) is a genetic entity with autosomal recessive inheritance. Mutations in genes (such as APOC2, APOAV, LMF-1, GPIHBP-1) that code for proteins that regulate the maturation, transport, or polymerization of lipoprotein lipase-1 are the most common causes, but not the only ones. The objective of this study was to report the first documented case in Ecuador. CLINICAL CASE: A 38-year-old man presented with chronic hepatosplenomegaly, thrombocytopenia, pancreatic atrophy, and severe hypertriglyceridemia refractory to treatment. A molecular analysis was performed by next generation sequencing that determined a deficiency of Lipoprotein Lipase OMIM #238600 in homozygosis. Genetic confirmation is necessary in order to establish the etiology of HTGS for an adequate management of this pathology.

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El síndrome de quilomicronemia familiar (SQF) es unaenfermedad autosómica recesiva rara, con una prevalencia1:200 000 - 1:1 000 000, y se caracteriza por quilomicronemiaen ayunas y niveles muy elevados de triglicéridos (> 880 mg/dl). LPL es el gen más frecuentemente afectado, luego APOC2,GPIHBP1, APOA5 y LMF1; todos ellos comprometen la función de la lipoproteinlipasa endotelial. El SQF suele presentarseen la infancia con dolor abdominal recurrente, xantomaseruptivos, retraso del crecimiento, pancreatitis y, en ocasiones,asintomático. El tratamiento convencional es la restriccióndietética de grasas. Se muestra el resultado clínico de 20 pacientes pediátricoscon SQF reclutados de 4 hospitales en Argentina.

Familial chylomicronemia syndrome (FCS) is a rare autosomalrecessive disease, prevalence 1:200,000 - 1:1,000,000, andis characterized by fasting chylomicrons and very hightriglycerides > 880 mg/dl. LPL is the most frequentlyaffected gene, then APOC2, GPIHBP1, APOA5, LMF1, all ofthem compromising the function of lipoproteinlipase. FCScommonly presents in childhood with recurrent abdominalpain, eruptive xanthomas, failure to thrive, pancreatitis, andsometimes asymptomatic. The conventional treatment isdietetic fat restriction. The clinical outcome of 20 pediatric patients with FCS recruited from 4 hospitals in Argentina is reported.

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RESUMEN Introducción. La cintura hipertrigliceridémica ha sido propuesta como un fenotipo con una fuerte asociación al síndrome metabólico, no se conoce la frecuencia de este fenotipo en adolescentes del Perú, incluyendo sus zonas andinas. Objetivo. Estimar la frecuencia de la cintura hipertrigliceridémica y su asociación con anormalidades metabólicas y otros factores en adolescentes peruanos de una región andina. Métodos. Estudio de fuente secundaria de diseño transversal analítico. Analizamos los datos de 397 adolescentes seleccionados aleatoriamente en dos escuelas públicas de la ciudad de Cajamarca. Se definió cintura hipertrigliceridémica como la presencia simultánea de una circunferencia de cintura incrementada (≥percentil 90 para edad y sexo) e hipertrigliceridemia sérica (≥110 mg/dL). Se realizó la estimación de la prevalencia de manera puntual y con su intervalo de confianza al 95%, también realizamos un análisis de regresión logística binaria para identificar factores asociados. Resultados. El fenotipo de cintura hipertrigliceridémica fue 2,01% (IC95%: 0,51 a 3,52). El componente más frecuente fue hipertrigliceridemia con 39,55% (IC95%: 34,61 a 44,48), mientras que la circunferencia de cintura incrementada afectó al 3,02% (IC95%: 1,21 a 4,83). El exceso de peso fue la única variable asociada con el fenotipo de cintura hipertrigliceridémica (OR ajustado: 62,7; IC95%: 6,7 a 587,9; p<0,001). Conclusiones. Dos de cien adolescentes de 11 a 17 años residentes de una región altoandina del Perú tuvieron el fenotipo de cintura hipertrigliceridémica. Dicho fenotipo estuvo asociado con el exceso de peso.

ABSTRACT Introduction. The hypertriglyceridemic waist has been proposed as a phenotype with a strong association with the metabolic syndrome. The frequency of this phenotype in adolescents from Peru, including Andes population is unknown. Objective. To estimate the frequency of the hypertriglyceridemic waist and its association with metabolic abnormalities and other factors in Peruvian adolescents from an Andean region. Methods. We performed a data secondary analysis through cross-sectional design. We analyzed 397 randomly selected adolescents from two public schools in the Cajamarca city. We defined hypertriglyceridemic waist as the simultaneous presence of increased waist circumference (≥ 90th percentile for age and sex) and serum hypertriglyceridemia (≥110 mg/dL). We estimated the point prevalence of hypertriglyceridemic waist and their 95% confidence interval, we also performed a binary logistic regression analysis to identify associated risks. Results. The phenotype of hypertriglyceridemic waist was 2.01% (95%CI: 0.51 to 3.52). The most frequent component was hypertriglyceridemia with 39.55% (95%CI: 34.61 to 44.48), while increased waist circumference affected 3.02% (95%CI: 1.21 to 4.83). Excess weight was the only variable association with hypertriglyceridemic waist phenotype (adjusted OR: 62.7; 95%CI: 6.7 - 587.9; p<0.001). Conclusions. Two of one hundred adolescents aged 11 to 17 years living in a high Andean region of Peru had the hypertriglyceridemic waist phenotype. This phenotype was associated with excess weight.

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Resumen: Durante el embarazo se producen cambios a nivel de la concentración de los lípidos debido a cambios fisiológicos con el fin de favorecer una adecuada nutrición fetal, estos cambios rara vez tienen consecuencias clínicas. Se presenta el caso clínico de una gestante que a las 31 semanas de edad gestacional se le diagnostica un estado hipertensivo del embarazo, constatándose hipertrigliceridemia severa con alto riesgo de pancreatitis. Se realizó recambio plasmático terapéutico y gemfibrozilo, con buena respuesta clínica.

Abstract: During pregnancy, changes occur at the level of lipid concentration due to physiological changes in order to promote adequate fetal nutrition, these changes rarely have clinical consequences. The clinical case of a pregnant woman is presented who at 31 weeks of gestational age is diagnosed with a hypertensive state of pregnancy, confirming severe hypertriglyceridemia with a high risk of pancreatitis. Therapeutic plasma exchange and gemfibrozil were performed, with a good clinical response.

Resumo: Durante a gravidez ocorrem alterações ao nível da concentração de lípidos devido a alterações fisiológicas de forma a promover uma nutrição fetal adequada, estas alterações raramente têm consequências clínicas. Apresenta-se o caso clínico de uma grávida que às 31 semanas de idade gestacional é diagnosticada com estado hipertensivo da gravidez, confirmando hipertrigliceridemia grave com elevado risco de pancreatite. Foi realizada plasmaférese terapêutica e gemfibrozil, com boa resposta clínica.

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Metabolic syndrome, or metabolic dysfunction related to obesity in dogs, is a set of factors that may predispose comorbidities secondary to obesity. Adjuvant therapy with an energy-restricted diet, especially with low levels of carbohydrate and fat, is essential for weight loss, in addition to controlling snacks intake. The aim of this study was to evaluate the biochemical profile of obese dogs compared to lean dogs, and also to compare these profiles before and after a 30-day treatment, thus evaluating the possibility of obesity-related metabolic dysfunction and the action of adjuvant dietary therapy in this condition. Cholesterol and its fractions (HDL, LDL and VLDL), triglycerides, systemic blood pressure and glycemia of obese and lean dogs were measured, and seven obese dogs were treated only with a low-calorie diet with low levels of fat and carbohydrates for 30 days; these patients were evaluated before and after treatment. Obese dogs showed higher levels of triglycerides than lean dogs, and dogs treated with low-calorie diet presented weight loss and better outcomes related to biochemical profile, especially triglycerides levels, after treatment.

A síndrome metabólica, ou disfunção metabólica relacionada à obesidade em cães, é um conjunto de fatores que podem predispor à obesidade. A terapia adjuvante com dieta com restrição calórica, especialmente com baixos níveis de carboidratos e gordura, é essencial para a perda de peso, além do controle da ingestão de petiscos. O objetivo do presente trabalho foi avaliar o perfil bioquímicos de cães obesos em comparação aos de escore corporal normal e avaliar esses perfis em um grupo de animais obesos antes e após restrição calórica de 30 dias, verificando a ocorrência da disfunção metabólica relacionada à obesidade e o papel da dieta como tratamento adjuvante desta condição. Colesterol e suas frações (HDL, LDL e VLDL), triglicérides, pressão arterial sistêmica e glicemia de cães obesos e em escore corporal normal foram mensurados, e sete cães obesos foram tratados somente com uma dieta de baixa caloria com baixos níveis de gordura e carboidratos durante 30 dias; estes pacientes foram avaliados antes e após o tratamento. Cães obesos demonstraram valores séricos de triglicérides maiores quando comparados aos cães com escore corporal normal, e cães tratados com a dieta hipocalórica obtiveram perda de peso significativa e melhores resultados relacionados ao perfil bioquímico, especialmente dos níveis de triglicérides após o tratamento.

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Atualmente, o estilo de vida antropomorfizado dos animais contribui para o intenso desenvolvimento da obesidade. A hiperlipidemia se apresenta como um dos efeitos deletérios do excesso de peso sobre a saúde dos cães, porém sendo pouco investigada. O termo hiperlipidemia refere-se ao aumento da concentração de lipídeos (colesterol, triglicérides ou ambos) séricos. Este estudo teve como objetivo realizar uma análise retrospectiva e estatística em animais que foram considerados obesos mediante inspeção de condição de escore corporal,visando correlacionar a obesidade com a presença de hiperlipidemias. Foram revisadas e analisadas 70 amostras sanguíneas de pacientes atendidos no Hospital Veterinário São Judas de outubro de 2018 a outubro de 2020 que já haviam realizado análises bioquímicas no Hospital; foram retiradas as informações destinadas a exames bioquímicos de triglicérides, colesterol e peso juntamente com a avaliação de condição de escore corporal (ECC) que foi feita em consulta clínica. Constatou-se que 24 (34,2%) amostras apresentaram resultados acima dos valores de referência para colesterol e triglicérides. Dentre esses 24 cães, 21 (87,5%) apresentaram ECC igual 7 ou maior, representando sobrepeso e/ou obesidade. Nenhum dos cães havia comparecido para atendimento pelo mesmo motivo e não houve queixa dos tutores tratando-se de sobrepeso, portanto, as alterações encontradas em exames bioquímicos foram um achado clínico laboratorial. Dos 21 cães componentes do grupo que apresentaram distúrbios metabólicos, 12 cães (57,2%) apresentaram ambos os valores de triglicérides e colesterol aumentados, apresentando então uma hiperlipidemia; 5 (23,8%) cães apresentaram hipercolesterolemia e 4 (19%) apresentaram hipertrigliricedemia. Essas alterações quando comparadas com um grupo controle de 19 animais sem alterações dignas de nota, revelaram valores de significância estatística, sugerindo alta frequência de hiperlipidemia em cães obesos, classificada como moderadamente elevados com importância clínica, havendo prevalência nas fêmeas.(AU)

Currently, the anthropomorphized lifestyle of animals contributes to the intense development of obesity. Hyperlipidemia presents itself as one of the deleterious effects of excess weight on the health of dogs, although it has been little investigated. The term hyperlipidemia refers to an increase in the concentration of serum lipids (cholesterol, triglycerides or both). This study aimed to perform a retrospective and statistical analysis on animals that were considered obese by inspecting the body condition score, aiming to correlate obesity with the presence of hyperlipidemia. Seventy blood samples from patients treated at Veterinary Hospital São Judas from October 2018 to October 2020 who had already performed biochemical analyzes at the Hospital were reviewed and analyzed; the information destined to biochemical tests of triglycerides, cholesterol and weight was removed together with the assessment of body condition score (BCS) that was made in clinical consultation. It was found that 24 (34.2%) samples showed results above the reference values ​​for cholesterol and triglycerides. Among these 24 dogs, 21 (87.5%) had BCSequal to 7 or greater, representing overweight and/or obesity. None of the dogs had attended for care for the same reason and there were no complaints from the guardians regarding being overweight, so the changes found in biochemical tests were a clinical laboratory finding. Of the 21 dogs in the group that presented metabolic disorders, 12 dogs (57.2%) had both increased triglyceride and cholesterol levels, and then presenting a hyperlipidemia; 5 (23.8%) dogs had hypercholesterolemia and 4 (19%) had hypertrigliricedemia. These changes when compared to a control group of 19 animals without significant changes, revealed values ​​of statistical significance, suggesting a high frequency of hyperlipidemia in obese dogs, classified as moderately high with clinical importance, with prevalence in females.(AU)

Actualmente, el estilo de vida antropomorfizado de los animales contribuye al intenso desarrollo de la obesidad. La hiperlipidemia es uno de los efectos nocivos del exceso de peso en la salud de los perros, pero se ha investigado poco. El término hiperlipidemia se refiere al aumento de la concentración de lípidos (colesterol, triglicéridos o ambos) en el suero. Este estudio tuvo como objetivo realizar un análisis retrospectivo y estadístico en animales considerados obesos mediante la inspección de su condición de puntuación corporal, con el fin de correlacionar la obesidad con la presencia de hiperlipidemia. Se revisaron y analizaron setenta muestras de sangre de pacientes atendidos en el Hospital Veterinario São Judas desde octubre de 2018 a octubre de 2020 que ya habían realizado análisis bioquímicos en el Hospital; Se retiró la información para las pruebas bioquímicas de triglicéridos, colesterol y peso, junto con la evaluación del estado del puntaje corporal (EPC), que se realizó en una consulta clínica. Se encontró que 24 (34,2%) muestras presentaron resultados por encima de los valores de referencia de colesterol y triglicéridos. Entre estos 24 perros, 21 (87,5%) tenían EPC igual a 7 o más, lo que representa sobrepeso y obesidad. Ninguno de los perros había acudido a ser atendido por el mismo motivo y no existían quejas de los tutores por sobrepeso, por lo que las alteraciones encontradas en las pruebas bioquímicas fueron un hallazgo de laboratorio clínico. De los 21 perros del grupo que presentaban alteraciones metabólicas, 12 perros (57,2%) tenían tanto triglicéridos como colesteroles elevados, presentando así hiperlipidemia; 5 (23,8%) perros tenían hipercolesterolemia y 4 (19%) tenían hipertrigliceridemia. Estas alteraciones, al compararlas con un grupo control de 19 animales sin alteraciones destacables, revelaron valores de significación estadística, sugiriendo una alta frecuencia de hiperlipidemia en perros obesos, clasificados como moderadamente altos con importancia clínica, con prevalencia en hembras.(AU)

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During aging, an increase in sedentary behaviour and a decrease in physical activity levels are observed. These factors may increase abdominal adiposity and triglyceride levels, which characterizes the hypertriglyceridemic waist (HW) phenotype, providing a high risk for cardiometabolic diseases. This study aimed to analyze the association between hypertriglyceridemic waist, physical activity level and sedentary behaviour in community-dwelling elderly. A population-based cross-sectional study was carried out, involving 316 elderlies (≥ 60 years) of both genders. The hypertriglyceridemic waist was diagnosed using high triglycerides (≥ 150 mg/dl) and increased waist circumference ≥ 88 and ≥ 102 cm values for women and men, respectively. The physical activity level and sedentary behaviour were evaluated using the IPAQ. The study included 173 women (54.7%) and 143 men (45.3%), with a mean age of 74.2 ± 9.8 years. The prevalence of HW was 27.1%, 47.7% insufficiently active and 24.1% high sedentary behaviour. The insufficiently active elderly (OR= 2.48; 95% CI: 1.31 - 4.71; p= 0.005) and with high sedentary behaviour (OR= 2.21; 95% CI: 1.04 - 4.32; p= 0.038) were associated positively with HW, indicating that elderly with insufficient physical activity levels and high sedentary behaviour showed themselves to approximately 2.5 and 2.2 times more likely to develop HW, respectively. Low physical activity level and high sedentary behaviour are associated with hypertriglyceridemic waist in community-dwelling elderly.(AU)

Durante o envelhecimento, observa-se aumento do comportamento sedentário e diminuições dos níveis de atividade física. Esses fatore podem aumentar a adiposidade abdominal e os níveis de triglicerídeos, o que caracteriza o fenótipo cintura hipertrigliceridêmica (CH), proporcionando um elevado risco para doenças cardiometabólicas. O objetivo deste estudo foi analisar a associação entre cintura hiper- trigliceridêmica, nível de atividade física e comportamento sedentário em idosos. Trata-se de um estudo epidemiológico, com delineamento transversal, de base populacional e domiciliar, realizado com 316 idosos (≥ 60 anos) de ambos os sexos. A cintura hipertrigliceridêmica foi definida a partir dos triglicérideos elevados (≥ 150 mg/dl) e circunferência da cintura alterada (≥ 88 cm para mulheres e ≥ 102 cm para homens). O nível de atividade física e o comportamento sedentário foram avaliados por meio do Questionário Internacional de Atividade Física (IPAQ). Participaram do estudo 173 mulheres (54,7%) e 143 homens (45,3%) com idade média de 74,2 ± 9,8 anos. A prevalência de CH foi 27,1%, 47,7% eram insuficientemente ativos e 24,1% tinham elevado comportamento sedentário. Os idosos insuficientemente ativos (OR= 2,48; IC95%:1,31 - 4,71; p= 0,005) e com elevado comportamento sedentário (OR= 2,21; IC95%:1,04 - 4,32; p= 0,038) foram positivamente associados à CH, indicando que os idosos com níveis de atividade física insuficientes e com elevado comportamento sedentário apresentaram, aproximadamente, 2,5 e 2,2 vezes mais chances de desenvolverem a CH, respectivamente. A inatividade física e o elevado comportamento sedentário estiveram associados à CH em idosos residentes em comunidade.(AU)

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La pancreatitis aguda es una causa rara de dolor abdominal durante el embarazo, puede ser potencialmente mortal para la madre y el feto. Se presenta con mayor frecuencia durante el tercer trimestre debido a un aumento progresivo de los triglicéridos y el colesterol como cambios fisiológicos del embarazo. Sin embargo, estos niveles no logran sobrepasar los 300 mg/dL; pacientes con niveles de triglicéridos por encima de 1000 mg/dL están en riesgo incrementado de desarrollar pancreatitis severa. Los criterios diagnósticos y protocolos de manejo no son específicos para esta patología durante el embarazo. El Tratamiento con aféresis puede ser usado como manejo primario durante el embarazo logrando una disminución rápida y segura de los niveles plasmáticos de triglicéridos. (provisto por Infomedic International)

Acute pancreatitis is a rare cause of abdominal pain during pregnancy, it can be life threatening for the mother and fetus. It occurs more frequently during the third trimester due to a progressive increase in triglycerides and cholesterol as physiological changes in pregnancy. However, these levels do not exceed 300 mg / dL; patients with triglyceride levels above 1000 mg / dL are at increased risk of developing severe pancreatitis. The diagnostic criteria and management protocols are not specific for this pathology during pregnancy. Treatment with apheresis can be used as primary management during pregnancy, achieving a rapid and safe decrease in plasma triglyceride levels. (provided by Infomedic International)

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Resumen La hipertrigliceridemia (HTG) es un problema que se presenta con frecuencia en la práctica clínica. Su prevalencia en adultos es cercana al 10%. El espectro varía desde una predisposición que resulta en HTG solo en presencia de sobrepeso considerable o consumo excesivo de alcohol hasta mutaciones graves muy raras que pueden conducir a HTG grave en la infancia, incluso en ausencia de factores adicionales, como en el síndrome de quilomicronemia familiar (FCS, familial chylomicronemia syndrome). Este es un trastorno autosómico recesivo poco frecuente del metabolismo del quilomicrón que causa una importante elevación de los triglicéridos (>10 mmol/885 mg/dl). Esta condición está asociada con un riesgo significativo de pancreatitis aguda recurrente. La aproximación diagnóstica se logra mediante la caracterización fenotípica, y el hallazgo de la alteración genética ayuda a dar un diagnóstico más preciso. Además, se ha propuesto una puntuación clínica para el diagnóstico de FCS, pero necesita más validación. Las opciones de tratamiento disponibles para reducir los triglicéridos, como los fibratos y los ácidos grasos omega-3, no son eficaces en los pacientes con FCS. Actualmente, el único tratamiento sigue siendo una dieta de por vida muy baja en grasas, que reduce la formación de quilomicrones. Finalmente, los inhibidores de la apolipoproteína C-III están en desarrollo y podrían constituir opciones de tratamiento para estos pacientes. Considerando lo anterior, el objetivo de este artículo es realizar una revisión general sobre la HTG grave, con énfasis en el FCS, basados en la literatura disponible más reciente.

Abstract Hypertriglyceridemia (HTG) is a problem that occurs frequently in clinical practice. Its prevalence in adults is close to 10% and it varies between regions. The spectrum ranges from a disposition that results in HTG only in the presence of considerable overweight and/or excessive alcohol consumption to very rare serious mutations that can lead to severe HTG in childhood, even in the absence of additional factors such as familial chylomicronemia syndrome (FCS). This is a rare autosomal recessive disorder of chylomicron metabolism that causes a severe elevation in triglyceride levels (>10 mmol/885 mg/dL). This condition is associated with a significant risk of recurrent acute pancreatitis. Because this is a genetic condition, the optimal diagnostic strategy remains the genetic test. In addition, a clinical score for the diagnosis of FCS has been proposed but it needs further validation. Available treatment options to lower triglycerides, such as fibrates or omega-3 fatty acids, are not effective in patients with FCS. Currently, the cornerstone of treatment remains a very low-fat, lifetime diet that reduces chylomicron formation. Finally, apolipoprotein C-3 inhibitors are under development and may eventually be treatment options for these patients. The objective of this article is to carry out a general review of severe HTG, with an emphasis on FCS and based on the most recent available literature.

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Introducción: El síndrome de ovario poliquístico se asocia con frecuencia a alteraciones cardiometabólicas; y su asociación con el fenotipo hipertrigliceridemia-obesidad abdominal ha sido poco estudiada en Cuba. Objetivo: Identificar la frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal en mujeres de edad mediana con síndrome de ovario poliquístico y su asociación con la resistencia a la insulina, trastornos del metabolismo de la glucosa y ateroesclerosis subclínica. Método: Estudio descriptivo, transversal, en 30 mujeres. Se tomaron variables clínicas: edad, peso, talla, índice de masa corporal, circunferencia de cintura y cadera, índice cintura/cadera, tensión arterial, además de concentraciones de glucosa, insulina, colesterol total, triglicéridos, HDL-c y LDL-c, e índice HOMA-IR. La aterosclerosis subclínica se evaluó por doppler carotideo y ecocardiograma (hipertrofia ventricular izquierda y grasa epicárdica). El fenotipo hipertrigliceridemia-obesidad abdominal se definió como triglicéridos elevados (≥ 1,7 mmol/L) y circunferencia de la cintura ≥ 80 cm. Resultados: La frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal fue 43,3 por ciento (13/30). Los valores medios de circunferencia abdominal, tensión arterial, así como de glucemia (p < 0,003), insulinemia (p = 0,028), triglicéridos (p < 0,0001), e índice HOMA-IR (p = 0,012) fueron más elevados en el grupo de mujeres con esa condición. A pesar de no haber diferencias significativas la frecuencia de mujeres con incremento del grosor íntima-media carotídeo y de grasa epicárdica fue superior en aquellas con el fenotipo. Conclusiones: La presencia del fenotipo hipertrigliceridemia-obesidad abdominal es frecuente en mujeres con síndrome de ovario poliquístico, y se asocia con alteraciones del metabolismo de la glucosa y la resistencia a la insulina. Este pudiera ser utilizado en la práctica clínica como un marcador de riesgo para alteraciones cardiometabólicas(AU)

Introduction: The polycystic ovary syndrome is frequently associated to cardiometabolic alterations; and its relation with the hypertriglyceridemic waist phenotype has been poorly studied in Cuba. Objective: Identify the frequency of the hypertriglyceridemic waist phenotype in middle age women with polycystic ovary syndrome and its association with insulin resistance, disorders in the glucose metabolism and subclinical atherosclerosis. Methods: Descriptive, cross-sectional study in 30 women. As clinical variables there were used: age, weight, size, body mass index, waist-hip circumference, waist/hip index, blood pressure; glucose, insulin, total cholesterol, triglycerides, HDL-c and LDL-c concentrations, and HOMA-IR index. Subclinical atherosclerosis was assessed by a carotid doppler and an echocardiogram (left ventricular hypertrophy and epicardial fat). The hypertriglyceridemic waist phenotype was defined as high triglycerides levels (≥ 1.7 mmol/L) and CC ≥ 80 cm. Results: The frequency of the hypertriglyceridemic waist phenotype was 43.3 percent (13/30). The mean values of abdominal circumference, blood pressure, as well as glycemia (p < 0.003), insulinaemia (p = 0.028), triglycerides (p < 0.0001), and HOMA-IR index (p = 0.012) were higher in the group of women with that condition. Although there were not significant differences, the frequency of women with increase of the carotid intima-media thickness and epicardical fat was higher in those with the phenotype. Conclusions: The presence of the hypertriglyceridemic waist phenotype is frequent in women with the polycystic ovary syndrome, and it is associated with alterations of the glucose metabolism and insulin resistance. This can be used in the clinical practice as a marker of risk for cardiometabolic alterations(AU)

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A hipertrigliceridemia é uma causa rara de pancreatite aguda, porém é uma etiologia bem estabelecida, e valores acima de 1000 mg/dL é suficiente para causar o quadro agudo. Objetivo: apresentar o caso de uma pancreatite induzida por hipertrigliceridemia. Método: relato de caso de paciente admitido em um serviço de urgência/emergência da atenção secundária, sendo constatado seu diagnóstico de pancreatite por tomografia de abdômen e a etiologia identificada por lipidograma. Resultados: O paciente ficou internado por 6 dias e foi submetido ao tratamento preconizado pelas diretrizes de pancreatite aguda, evoluindo com estabilidade hemodinâmica e melhora do quadro.

Hypertriglyceridemia is an unusual cause of acute pancreatitis, however it is a well­established etiology, and values above 1000mg / dL are sufficient to induce the acute condition. Objective: to present the case of pancreatitis induced by hypertriglyce­ridemia. Method: case report of a patient admitted to an urgency / emergency service of secondary care, with his diagnosis of pancreatitis verified by abdominal tomography and the etiology identified by lipidogram. Results: The patient was hospitalized for 6 days and underwent the treatment recommended by the guidelines of acute pancreatitis, evolving with hemodynamic stability and improvement of the condition.

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Resumen La pancreatitis aguda se considera un proceso inflamatorio del páncreas, el cual resulta de la activación de enzimas digestivas liberadas por esta glándula. Esta entidad patológica está asociada con múltiples etiologías. Caso: varón de 37 años de edad con cuadro de dolor abdominal en hipogastrio irradiado a la espalda. En el examen físico se encontró taquicárdico, hipertenso, con dolor abdominal a la palpación profunda sin signos de irritación peritoneal. Los paraclínicos mostraban una elevación de los reactantes de fase aguda y amilasa pancreática, los estudios imagenológicos mostraban signos de pancreatitis aguda. Discusión: la pancreatitis asociada con hipertrigliceridemia se presenta entre el 0,5 % al 1 % de los casos. La tríada inicial del manejo es dieta absoluta, hidratación intravenosa y analgésicos. En el caso de la hipertrigliceridemia, se puede manejar con hipolipemiantes orales o, en caso de niveles mayores de 1000 mg/dL, se puede usar el recambio plasmático, el cual tiene buena efectividad y disminuye los valores a rangos de normalidad en el 80 % de los casos con la primera sesión.

Abstract Introduction: Acute pancreatitis is considered an inflammatory process of the pancreas, which results from the activation of digestive enzymes released by this gland. This pathological entity is associated with multiple etiologies. Case: 37-year-old male with hypogastrium pain irradiated to the back. On physical examination, the patient was tachycardic, hypertensive, with abdominal pain on deep palpation without signs of peritoneal irritation. Laboratory tests showed an elevation of acute phase reactants and pancreatic amylase, and imaging studies showed signs of acute pancreatitis. Discussion: Pancreatitis associated with hypertriglyceridemia occurs in 0.5 to 1% of cases. The initial management triad is a clear liquid diet, intravenous hydration, and analgesics. Hypertriglyceridemia can be managed with oral hypolipidemic drugs. When levels are higher than 1 000 mg/dL, plasma exchange can be used due to its good effectiveness, decreasing the values to normal ranges in 80% of the cases with the first session.

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