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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #11 2026

This review aims to examine how sHTG is defined across various clinical guidelines and to summarise its prevalence and incidence
in the general adult population worldwide. The authors searched Embase and MEDLINE in March 2025 for clinical guidelines and Dyslipidaemia
epidemiological studies focusing on adults, using the Condition, Context, Population (CoCoPop) framework to identify relevant records.
Records reporting on narrow populations were excluded. The authors then extracted data, performed formal risk of bias assessments to
exclude flawed studies, and calculated pooled prevalence estimates using a random-effects model stratified by sHTG type and specific
TG threshold groups.

The authors identified 18 records consisting of clinical guidelines or consensus statements that defined sHTG and 16 studies reporting
prevalence and/or incidence estimates. The 18 guidelines/consensus documents were published between 1992 and 2021 and were
predominantly from the United States, with a few from Europe, India, Latin America, and Iran. Almost all of the United States guidelines,
including the more recent 2025 American Association of Clinical Endocrinology guidelines, define sHTG using a threshold of TG ≥500
mg/dL. The Indian, Latin American, and Iranian guidelines all aligned with this threshold. In contrast, European guidelines (such as those
from the European Society of Cardiology) required higher thresholds, defining “severe” as >880 mg/dL (10 mmol/L). Most guidelines also
recommended fasting samples for TG measurement. A few supported the use of non-fasting lipid profiles for routine screening but still
recommended fasting samples in specific situations.

Forest plot of the prevalence rates of unspecified/mixed primary or secondary sHTG defined as TG
>500 mg/dL (>5.6 mmol/L), stratified by region (n = 11).

*Pooled Europe includes Sweden and Spain.
CI, confidence interval; n, number of cases; N, sample size; NHANES, National Health and Nutrition Examination Survey; sHTG, severe hypertriglyceridaemia; TG,
triglycerides; US, United States.

The 16 epidemiological studies were conducted primarily in Europe, the United States, and China. Fourteen studies were included for
prevalence estimates for primarily unspecified/mixed sHTG across three different TG threshold groups: >500 mg/dL; >886 mg/dL; and
>1000 mg/dL. Studies on primary sHTG were limited, reporting a prevalence of 1:125 (0.80%) and 1:667 (0.15%) in a US and Spanish
study, respectively, for TG >500 mg/dL. For unspecified/mixed sHTG defined as TG >500mg/dL, the pooled overall prevalence was 1:88
(1.14%). The pooled prevalence was highest in China at 1:64 (1.56%) and lowest in Europe at 1:159 (0.63%).

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