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fat store - energy source, thermal insulation, adipocytes act as a mechanical cushion eg round kidneys
2ndary cause - alcohol, uncontrolled diabetes, drugs eg isotretinoin
main worry is pancreatitis 

''Ix'' - Urinalysis, fasting lipid and glc, LFT, U/E, TSH, creatine Kinase

''Aims ....''
fasting TG <1.7 (but any reduction dec risk of pancreatitis)
If >10 ? refer to secondary care (>20 urgently unless poor glc control or xs alcohol is clearly cause)

''Mx ''
lifestyle, esp alcohol and diabetes
statin unless normal cholesterol or CI
if still >5.6 after 3/12 then ...
Omega-3 1-2g bd (unless unable to take fish)
If still >5.6 consider ? refer  ? for fibrate or nicotinic acid 

''Causes of secondary ....''
|nephrotic syndrome|chol ++ |TG (+)|hypothyroidism|chol ++| TG +|biliary obstruction|chol+ |TG (+)|
|pregnancy|chol +||myeloma|chol+||porphyria|chol +||
|steroids|chol+|TG +|obesity|chol +|TG +|diabetes mellitus|chol (+)|TG ++|
|renal failure||TG +|excess ethanol intake||TG ++|beta blockers||TG +|
|thiazide diuretics|chol +|TG +|isotretinoin||TG+|oral contraceptive pill||TG+|
|lipodystrophies||TG+|glycogen storage disease||TG+||||