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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Ways To Reduce Triglycerides And Improve HDL Levels

Hi, I m having high LDL (190) and low HDL (25). Inaddition my TGL is 306. I m a little diabatic (fasting sugar 120). Also my kidney function is not normal (gfr 53%). I m taking Lipitor 10 mg, Januvia 50 mg daily. Could you suggest me how to reduce tryglyceride and improve HDL? Do I have to take any baby Aspirin? My liver enzyme is also higher side and stopped taking Lipitor. Could you please advise me?
Thu, 1 Oct 2015
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Diabetologist,  's  Response
Hi, y

Thanks for your question.

After going through your question, I can understand your concern.

Considering the fact that you have diabetes, dyslipidemia, CKD stage III (chronic Kidney disease), you are at high risk for macro vascular complications of diabetes (Heart disease, stroke, peripheral vascular diseases).

In such condition it is advisable to keep Lipid Profile in optimal range (at least 50% reduction in your current LDL, HDL should be more than 35 and Tryglycerides should be less than 150)

Therefore there is need to increase dose of Lipitor (atorvastatin) to 40mg and addition of Tab Fenofibrate.
Additionally regular exercise as tolerated helps in increasing the HDL.

But increasing the dose of atorvastatin with addition of Fenofibrate increases the chances of elevation of liver enzymes and myopathy, this risk further increases with decreasing Kidney function (GFR).

So there need a close monitoring of kidney function, Liver enzymes and sign & symptoms of myopathy.

Hope this helps you, if so do vote as helpful.
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Suggest Ways To Reduce Triglycerides And Improve HDL Levels

Hi, y Thanks for your question. After going through your question, I can understand your concern. Considering the fact that you have diabetes, dyslipidemia, CKD stage III (chronic Kidney disease), you are at high risk for macro vascular complications of diabetes (Heart disease, stroke, peripheral vascular diseases). In such condition it is advisable to keep Lipid Profile in optimal range (at least 50% reduction in your current LDL, HDL should be more than 35 and Tryglycerides should be less than 150) Therefore there is need to increase dose of Lipitor (atorvastatin) to 40mg and addition of Tab Fenofibrate. Additionally regular exercise as tolerated helps in increasing the HDL. But increasing the dose of atorvastatin with addition of Fenofibrate increases the chances of elevation of liver enzymes and myopathy, this risk further increases with decreasing Kidney function (GFR). So there need a close monitoring of kidney function, Liver enzymes and sign & symptoms of myopathy. Hope this helps you, if so do vote as helpful.