Incidence, predictors and patterns of care of patients with very severe hypertriglyceridemia in Ontario, Canada: a population based cohort study
Background The incidence of severe (S HTG) and very severe hypertriglyceridemia (VS HTG) among Canadians is unknown. This study aimed to determine the incidence, characteristics, predictors and care patterns for individuals with VS HTG. Methods Using linked administrative healthcare databases, a population based cohort study of Ontario adults was conducted to determine incidence of new onset S HTG (serum triglycerides (TG) 10 20 mmol/L) and VS HTG (TG 20 mmol/L) between 2010 and 2015. Socio demographic and clinical characteristics of those with VS HTG were compared to those who had no measured TG value 3 mmol/L. Univariable and multivariable logistic regression were used to determine predictors for VS HTG. Healthcare patterns were evaluated for 2 years following first incidence of TG 20 mmol/L. Results Incidence of S HTG and VS HTG in Ontario was 0.16 and 0.027% among 10,766,770 adults =18 years and 0.25 and 0.041% among 7,040,865 adults with at least one measured TG, respectively. Predictors of VS HTG included younger age [odds ratios (OR) 0.64/decade, 95% confidence intervals (CI) 0.62 0.66] male sex (OR 3.83; 95% CI 3.5 4.1) diabetes (OR 5.38; 95% CI 4.93 5.88) hypertension (OR 1.69; 95% CI 1.54 1.86) chronic liver disease (OR 1.71; 95% CI 1.48 1.97) alcohol abuse (OR 2.47; 95% CI 1.90 3.19) obesity (OR 1.49; 95% CI 1.13 1.98) and chronic kidney disease (OR 1.39; 95% CI 1.19 1.63) Conclusion The 5 year incidence of S HTG and VS HTG in Canadian adults was 1 in 400 and 1 in 2500, respectively. Males, those with diabetes, obese individuals and those with alcohol abuse are at highest risk for VS HTG and may benefit from increased surveillance.
Lipids in health and disease