Duke researchers are investigating how a dangerous but under-recognized lipid disorder is identified and treated in real-world clinical practice.
The retrospective study, led by endocrinology fellow Maria S. Martinez-Cruz, MD, with co-investigators and cardiologists Drs. Nishant P. Shah and Neha J. Pagidipati, will examine electronic health records from Duke's tertiary care center spanning 2020 through 2025 focusing on patients with severe hypertriglyceridemia and extreme hypertriglyceridemia.
Both conditions raise the risk of acute pancreatitis, cardiovascular disease, and other serious complications, yet remain inconsistently managed.
Severe hypertriglyceridemia affects roughly 1 in 100 people, while extreme cases span a spectrum from rare genetic forms to a more common multifactorial version affecting about 1 in 500 Americans.
Left untreated, the disorder can progress to diabetes, fatty liver disease, and heart disease, while imposing a heavy toll on patients through chronic pain, hospitalizations, and complex medication regimens.
With new multi-society treatment guidelines and emerging therapies — including apolipoprotein C-III inhibitors like Olezarsen — now available, the study aims to close the gap between clinical recommendations and everyday practice.
Researchers will track how patients are evaluated, how quickly treatment is escalated, and how many go on to experience pancreatitis, cardiovascular events, or emergency care.
The findings are expected to inform strategies for earlier detection and more consistent, guideline-based care for this high-risk patient population, Martinez-Cruz said.
Funding is awarded through the Ionis Cardiometabolic Young Investigator Grant Program by Ionis Pharmaceuticals, which offers $50,000 per year for up to two years for residents, fellows, and junior faculty focusing on severe hypertriglyceridemia and cardiometabolic diseases.