A 30-year-old woman experienced abdominal pain after a buffet and was hospitalized, where she was diagnosed with acute pancreatitis. Despite treatment, she died two days later from multiple organ failure. Her triglyceride levels were found to be 26 times higher than normal. The doctor explained the reason for her rapid deterioration was linked to a critical error she made before her death.
Dr. Xu Bing-yi, Deputy Superintendent of Taiwan's Annan Hospital, shared on Facebook that the 30-year-old woman went to a high-end hotel buffet with friends. In the middle of the night, she suddenly developed severe upper abdominal pain and was rushed to the emergency room. Tests revealed very high blood amylase levels, leading to a diagnosis of severe acute pancreatitis, requiring immediate hospitalization.
The next morning, her condition worsened significantly, with symptoms like shortness of breath, deteriorating kidney function, and low blood calcium. She was transferred to the Intensive Care Unit (ICU) and required intubation and a ventilator. However, her condition progressed extremely rapidly; she went into shock the following day and unfortunately passed away.
Regarding the cause of death, doctors learned during treatment that the woman had a history of high triglycerides. She had previously taken medication to control it but had stopped the medication on her own because she didn't want to take long-term drugs. Tragically, after her death, her triglyceride test results came back, showing an astonishingly high level of over 4,000 mg/dL (normal level: should not exceed 150 mg/dL). This was a key factor in the rapid worsening of her condition.
Xu explained that when blood triglyceride (TG) concentration exceeds 150 mg/dL, it is diagnosed as hypertriglyceridemia. It can be classified by severity:
Mild to Moderate: 150–499 mg/dL.
Severe: ≥ 500 mg/dL.
Very Severe: ≥ 1000 mg/dL (very high risk of acute pancreatitis).
Long-term excessively high triglycerides pose serious threats to overall health:
Acute Pancreatitis: The most dangerous acute complication, potentially leading to death, pancreatic necrosis, or multiple organ failure.
Atherosclerotic Cardiovascular Disease (ASCVD): Increases the risk of heart attack, stroke, and peripheral artery disease.
Liver Health Issues: Easily leads to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), liver inflammation, fibrosis, and even cirrhosis.
Eye and Skin Manifestations: Extremely high levels (>1000 mg/dL) can cause eruptive xanthomas (small, yellowish-red bumps on the skin) and lipemia retinalis (retinal blood vessels appearing creamy-colored).
Xu stated that the goals of treating hypertriglyceridemia are to prevent acute pancreatitis (for severe cases) and reduce cardiovascular risk (for all patients). He outlined two key directions for prevention and treatment:
1. Lifestyle Modifications
This is the primary step in treating hypertriglyceridemia, focusing on five areas:
Weight Control: Losing 5–10% of body weight can lower triglycerides by about 20%.
Diet Management: Reduce refined carbohydrates, sugary drinks, and high-fructose foods.
Limit Alcohol: Alcohol significantly increases TG synthesis; abstinence is recommended.
Fat Intake: For severe cases (TG ≥ 500 mg/dL), a strict very-low-fat diet is necessary.
Exercise: At least 150 minutes of moderate-intensity aerobic exercise per week.
2. Medication
Statins: The foundation for preventing cardiovascular disease; can lower TG by 10–30%.
Fibrates: Such as Fenofibrate, can reduce TG by 20–50%.
High-Dose Prescription Fish Oil (Omega-3): Prescription-grade fish oil (e.g., Icosapent ethyl) has been proven to significantly reduce cardiovascular events in high-risk patients.
New RNA Therapies: Such as Plozasiran or Olezarsen, which precisely target genetic mechanisms for lipid lowering, have shown excellent efficacy in clinical trials.
Xu emphasized: When blood triglyceride levels exceed 500 mg/dL, it is crucial to seek medical treatment promptly and take medication strictly as prescribed, as stopping medication can be fatal.
