Can high lipids and family history affect heart risk at 23?

Question

Hi doctor,

My brother, who is 23 years of age, received a lipid profile. The results showed that his triglycerides are 334 mg/dL, and we do not know how to proceed with this problem.

He is leading an unhealthy lifestyle, consuming too much fast food, and having no physical activity. However, it did not occur to us that his triglyceride levels would be so high at his age. His LDL cholesterol level is 142 mg/dL (high range), and the level of his fasting glucose is 108 mg/dL (elevated).

The fact that he does not have any symptoms of chest pain or abdominal pain makes us less concerned because he has not experienced any health issues related to these parameters before. However, I read that very high levels of triglycerides may lead to pancreatitis, and we are worried about this issue.

Is it necessary to take him to a physician as soon as possible, or could we just wait for our scheduled appointments? Furthermore, his father had a heart attack at the age of 52, and we are also afraid of the family history.

Any information on this subject would be greatly welcomed.

Thank you very much.

Answer 1

Hi,

Welcome to icliniq.com.

I am sorry to hear about your brother.

Your brother's laboratory results (triglycerides 334 mg/dl, LDL-cholesterol 142 mg/dl, and fasting glucose 108 mg/dl) certainly require medical supervision. Still, in the lack of any symptoms, such values are not considered a reason for visiting an emergency department.

In regard to the level of triglycerides, one should note that a level of 334 mg/dl belongs to the category of high values (200 to 499 mg/dl). Triglyceride elevation raises the long-term risk of heart disease, but it does not indicate a risk of pancreatitis.

The risk of developing acute pancreatitis significantly increases at levels higher than 500 mg/dl and especially higher than 1,000 mg/dl. Thus, while elevated levels of triglycerides certainly can lead to pancreatitis, the level of your brother's triglycerides is not likely to provoke the development of pancreatitis right away. Nonetheless, if he experiences severe abdominal pain or vomiting, he should immediately consult a doctor.

High triglycerides, slightly high LDL, and a fasting glucose level of 108 mg/dl, which falls under the impaired fasting glucose (prediabetic category), indicate the presence of metabolic problems that are mostly linked to the condition of insulin resistance. Such a combination is usually found in individuals who lead a sedentary life, along with consuming high amounts of junk food and fast food.

In his case, the family history of heart ailments is noteworthy since the patient's father had a heart attack at the age of 52. It is essential for him to be conscious of this problem. On a more positive note, being just 23 years old means he can change his lifestyle significantly to see the desired results. There will be an improvement in triglyceride levels by 30 to 50% in a matter of weeks to months.

The first thing he needs to do is improve his nutrition. He needs to cut down on refined carbs and sugars, such as sodas, sweets, white bread, fast foods, and any processed products, which contribute largely to high triglycerides. He needs to concentrate on a well-balanced, nutritious diet based on plenty of vegetables, protein food (such as fish, chicken, and beans), and some healthy fats from nuts and olive oil. If he drinks alcohol, it would be better for him to refrain from it now, because it contributes significantly to high levels of triglycerides.

It is also crucial to exercise regularly. This is because he will need to ensure that he does at least 150 minutes of aerobic exercise per week, such as brisk walking, cycling, swimming, and whatever he finds comfortable. A mere five to 10 percent loss of body weight can help him reduce triglycerides, LDL cholesterol, and blood glucose levels.

The best course of action would be to make an appointment with his primary care physician or lipid specialist in the following weeks. This will enable him to go through another fasting lipid profile test, have an HbA1C test to establish the average blood glucose levels in the last three months, and have some liver function tests to check for liver problems because it is a common condition among people with elevated triglycerides. Other tests will depend on other factors that could cause high triglycerides. The primary care physician will make the decision based on the results of these tests.

Although there could also be a role of genetics, especially considering the family history, lifestyle changes still remain the main modifiable factors and can have a significant effect.

Finally, instead of panicking, consider this an opportunity. This is because these results do not mean that your brother has any heart disease and is in imminent danger. On the contrary, it is an early warning that will enable him to make the necessary changes now, which will have a beneficial influence on his health in the future.

There is a low risk of pancreatitis at this level of triglycerides. Nevertheless, he needs to schedule his visit to the doctor soon and start making healthy changes in his lifestyle.

I wish you, brother, all the best.

I hope that this is helpful for you.

Best regards.