What is triglyceride?

What is triglyceride? Triglyceride is a type of fat found in the blood. There are mainly two types of lipids (blood fats) in the blood: triglycerides and cholesterol. Hyperlipidaemia is a medical term used to describe high fat levels in the blood. It is commonly referred to as “high cholesterol”, but in reality both cholesterol and triglyceride elevations mean high blood fats. Cholesterol is a fat product that circulates in our blood by binding to proteins called lipoproteins. It is produced by the liver for cell health and many body functions. Foods like eggs, red meat, offal, cream and full‑fat cheese also contain high levels of cholesterol. A certain amount of cholesterol is necessary for cell health, but when intake exceeds a certain level, health problems begin. Compared with people with normal cholesterol levels, those with high cholesterol are at higher risk of cardiovascular disease, stroke and other health issues. The higher the cholesterol, the higher the risk that these problems occur. When we eat, the body converts calories not used immediately into triglycerides. As one of the body’s energy storage forms, triglycerides are stored in fat cells. They are released into the blood by certain hormones to meet energy needs, especially between meals and during prolonged fasting, supplying tissues with energy. Triglycerides are normally present in the blood to some degree; however, elevated levels can lead to a variety of health problems. According to studies, 3 out of 10 adults in Türkiye have high triglycerides. What should the optimal triglyceride value be? In the standard lipid test (blood fats), total cholesterol, LDL cholesterol ("bad"), HDL cholesterol ("good") and triglyceride levels are measured. The ideal triglyceride level is below 150 mg/dL (1.7 mmol/L). Values between 150 and 200 mg/dL (2.28 mmol/L) are considered borderline high, Values between 200 and 500 mg/dL (5.7 mmol/L) are high, and above that very high. Very high triglycerides require urgent treatment. Generally, a total cholesterol above 200 mg/dL (2.28 mmol/L) is considered high. However, safe and target values for blood fats may vary depending on a person’s history and current health status. This assessment is made by the physician overseeing care. Blood fats are often checked after 8–12 hours of fasting. In some special cases, non‑fasting measurements may also be considered, guided by the physician. Mild to even moderate elevations in triglycerides are usually asymptomatic. However, if they remain high for a long time, they can cause serious health problems. Symptoms of high triglycerides include: • Small fat deposits on the skin called xanthomas • Abdominal pain due to fatty liver • Chest pain, shortness of breath, palpitations in the long term • Numbness, lightheadedness, weakness, dizziness, blurred vision • Headache; more rarely, confusion and loss of consciousness due to narrowing of the vessels supplying the brain • Very high triglycerides can cause pancreatitis (inflammation of the pancreas) leading to abdominal pain, fever, nausea, vomiting and loss of appetite. This is an emergency requiring hospitalisation and treatment. Which diseases do high triglycerides cause? High LDL (“bad” cholesterol) is the main cause of cardiovascular disease. However, people with high triglycerides also have a higher risk of cardiovascular disease than those with normal levels. At high triglyceride levels, fat deposits accumulate on vessel walls and form plaques. Over time, these plaques grow, causing narrowing and occlusion of the vessels. High triglycerides increase the risk of: • Heart attack due to coronary artery disease • Stroke due to cerebral vessel occlusion (cerebrovascular disease) • Peripheral arterial disease (occlusion in arteries supplying the arms and legs) Many other factors increase risk: age, family history of early cardiovascular disease, male sex, smoking, hypertension, overweight, diabetes, stress, other comorbidities and medications. Individual risk is evaluated by the physician, targets are set and a prevention, treatment and follow‑up plan is made. High triglycerides can also cause various types of skin fat deposits called xanthomas. High triglycerides cause fatty liver and splenomegaly and can enlarge these organs. Fatty liver can lead to 10–20% liver inflammation. This state carries risk of cirrhosis and liver cancer. Very high triglycerides may cause pancreatitis. Inflammation of the pancreas is a life‑threatening emergency. What are the causes of high triglycerides? • Excessive consumption of animal fats • Excessive consumption of high‑carbohydrate foods • Eating more calories than expended can raise triglycerides Other contributors include: • Inactivity • Weight gain • Conditions such as insulin resistance, uncontrolled diabetes, hormonal disorders (hypothyroidism, Cushing’s syndrome), kidney failure • Alcohol • Certain medications In some cases, high triglycerides are due to genetic factors. How can triglycerides be lowered? Two basic approaches: lifestyle modification and medication therapy. Lifestyle changes Healthy lifestyle measures should be applied at all triglyceride levels. Medical nutrition therapy, exercise and weight loss form the basis. To lower triglycerides, note the following: • Carbohydrate‑rich foods with simple sugars and high glycaemic index (bread, pastries, fruit juices, sweets) • Various animal fats such as red meat, butter, fried foods, saturated fats • Reduce intake of full‑fat dairy and restrict calories Additionally: • Consume 1–2 portions of fatty fish per week • Limit or avoid alcohol • Lose weight if overweight • Regular exercise — especially aerobic activity like brisk walking — effectively lowers triglycerides Treatment is tailored by the physician according to risk and triglyceride level. Medication: Many lipid‑lowering therapies aim to reduce LDL cholesterol and triglycerides. Medication is not required for every elevation. The decision to start medication is made by the physician, considering age, family history and comorbidities. Products containing omega‑3 fish oil can also be used to lower triglycerides. Even when medication is started, healthy diet and exercise should never be stopped. If high triglycerides are diagnosed and treatment is planned, repeat lipid measurements are scheduled, initially at 6–8 weeks. All treatment should be conducted under medical supervision. How often should blood fat tests be performed? Blood lipids: • Every 5 years starting at age 18–20 • Every 2 years in men over 40 and women over 50 or post‑menopause Depending on risk factors, earlier and more frequent screening may be appropriate; the supervising physician will plan this. Screening should include total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol.