Triglycerides

Serum triglyceride concentration mainly represents the lipid
contained within very-low density lipoproteins (VLDLs) in serum.
VLDLs are secreted by the liver following breakdown of adipose tissue
stores. Increased triglyceride (in VLDLs) indicates one or more of the
following:
 a negative energy balance – and hence adipose tissue breakdown
 insulin resistance – which facilitates adipose breakdown
 glucagon release (in response to hypoglycaemia) – which
promotes fat breakdown
 obesity – associated with both insulin resistance and excessive
adipose deposits

Hyperlipidaemia is a common effect of using SGLT2 inhibitor drugs
(e.g. velagliflozin, canagliflozin, ertugliflozin, dapagliflozin). Generally
the increase in serum triglycerides is small and inconsequential
although far higher concentrations are sometimes seen and clinical
hyperlipaemia can result. It is very important to monitor serum
triglyceride concentrations from a few days after starting SGLT2

inhibitor therapy. Ensuring adequate caloric intake (non-
glycaemic/non-hyperinsulinaemic feeds) is important in limiting fat

mobilisation in such cases.
High triglyceride concentrations (alongside hyperglycaemia) are seen
in the presence of diabetes mellitus due to failure of insulin to control
triglyceride concentrations. Such cases are likely to show weight loss
and polydipsia and a good appetite (often related to PPID).
Several confusing descriptive terms are used for increased plasma
triglyceride.

 “Hypertriglyceridaemia” is a general term for increases above
normal values (typically >0.6 mmol/L).
 “Hyperlipidaemia” refers to mild increases in serum triglycerides
(0.7-5.6 mmol/L) without grossly visible lipaemia or adverse

health consequences. Commonly seen in cases of mild/short-
lived nutritional deprivation or as a long-term status in

otherwise normal pregnant or obese ponies and donkeys.
 “Severe hypertriglyceridaemia” describes moderate (to marked)
increases in serum triglycerides (>5.6 mmol/L and sometimes as
high as 20 mmol/L) without grossly visible lipaemia or apparent
adverse health consequences. This is commonly encountered in
horse breeds subject to prolonged feed withdrawal and/or
critical care illness
 “Hyperlipaemia” refers to moderate to marked increases in
serum triglycerides (>5.0 mmol/L and sometimes as high as 50
mmol/L) with grossly visible lipaemia and clinical signs of
dullness and inappetance.

See also
Endocrinopathic laminitis
Glucose
Insulin