Abstract
Hypertriglyceridemia in association with hypernatremia was reported in a few children; however, studies exploring this association are limited. To determine the pattern of change in serum triglycerides levels in hypernatremia patients. A prospective case-control study done at North West Armed Forces Hospital, Tabuk, Saudi Arabia from April 2008 to March 2011. serum triglycerides and sodium were measured in 16 patients with hypernatremic dehydration as a study group and 14 patients with isonatremic dehydration as a control group. The trend of serum sodium and triglycerides was followed during treatment in the study group. There were 6 boys and 8 girls in the control group (isonatremic dehydration). Their age ranged between 4 months and five years (M±SD = 1.7±1.3 years). In the study group (hypernatremic dehydration), there were 6 boys and 10 girls. The age range was 2-14 months (M±SD = 0.6±0.4 years). The serum sodium and triglycerides (M±SD = 165.8±9.1 mmol/l, 5.1±8.1 mmol/l respectively) were significantly higher compared with the control group (M±SD = 137.5±3.9 mmol/l, 0.7±0.3 mmol/l and P < 0.001, P < 0.05 respectively). Duration of symptoms in patients with hypernatremic dehydration (M±SD = 2.9±2.4 days) were comparable to control group (M±SD = 2.0±0.9 days, P = 0.18). Four patients from the study group had normal serum triglycerides (M±SD = 1.1±0.1 mmol/l). With treatment, serum sodium was normalized in all patients followed by serum triglycerides. Hypertriglyceridemia is present in most children with hypernatremia and it disappears when serum sodium returns to normal.
Highlights
Hypertriglyceridemia in association with hypernatremia was reported in a few children; studies exploring this association are limited
Serum triglycerides of the study group (M±standard deviations (SD) = 5.1±8.1 mmol/l) was significantly higher compared with the control group (M±SD = 0.7±0.3 mmol/l, P = 0.04)
One explanation is the enhanced hepatic triglyceride formation, as a direct action of hypernatremia; [30] or indirectly, through hormonal mediators released in response to hyperosmolar state, [31] stress [32, 33] or lesions of ventromedial hypothalamus (VMH). [34, 35] Hypertriglyceridemia has been attributed, both in human [19] and laboratory animals, [31, 36, 37] to the destructive lesions of (VMH)
Summary
Hypertriglyceridemia in association with hypernatremia was reported in a few children; studies exploring this association are limited. The trend of serum sodium and triglycerides was followed during treatment in the study group. Results: There were 6 boys and 8 girls in the control group (isonatremic dehydration). Their age ranged between 4 months and five years (M±SD = 1.7±1.3 years). In the study group (hypernatremic dehydration), there were 6 boys and 10 girls. Duration of symptoms in patients with hypernatremic dehydration (M±SD = 2.9±2.4 days) were comparable to control group (M±SD = 2.0±0.9 days, P = 0.18). Four patients from the study group had normal serum triglycerides (M±SD = 1.1±0.1 mmol/l). Serum sodium was normalized in all patients followed by serum triglycerides. Conclusion: Hypertriglyceridemia is present in most children with hypernatremia and it disappears when serum sodium returns to normal.
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