Clinical correlates of triglyceride levels and multiorgan dysfunction in adults

*Corresponding author: Dhanalakshmi Vinoth Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Clinical correlates of triglyceride levels and multiorgan dysfunction in adults DHANALAKSHMI VINOTH.B *, SIVASHRI.K, SHINYCINDERELLA. B. R and NIVEDHITHA.S Faculty of Allied Health Sciences, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 Publication history: Received on 22 August 2025; revised on 03October 2025; accepted on 06 October 2025 Article DOI: https://doi.org/10.30574/wjbphs.2025.24.1.0878 Abstract Background: Multi-organ dysfunction syndrome (MODS) is a life-threatening condition where two or more organs in the body fail to function properly. WHO classifies triglyceride levels as mild (<200 mg/dL), moderate (200–500 mg/dL), and severe (>500 mg/dL). Aim and objectives: Aim: The Aim of the study is to study and access clinical correlates of triglyceride levels and multi organ dysfunction in adults Results: Among the 316participants, 55% of individuals had normal triglyceride levels, 23% had mild elevation, and 22% had moderate elevation. Among the conditions studied, hyperlipidemia, hypertension (HTN), hyperthyroidism, and metabolic-associated steatotic liver disease (MASLD) showed statistically significant associations with elevated triglyceride levels, with p-values of 0.011, 0.037, 0.001, and 0.015, respectively. Total cholesterol (r = 0.4530), LDL (r = 0.377), VLDL (r = 0.48), and the cholesterol: HDL ratio (r = 0.307), all with p-values < 0.001 indicates significant positive correlation of triglycerides. Conclusion: In conclusion, the study highlights a significant association between elevated triglyceride levels and conditions such as obesity, alcohol use, smoking, diabetes, hypertension, hyperlipidemia, hyperthyroidism, and MASLD. Elevated triglyceride levels are closely linked to increased risk of multi-organ dysfunction and related comorbidities. Keywords: Triglyceride; Multiorgan Dysfunction; Hypertriglyceridemia; Metabolic Associated Steatotic Liver Disease 1. Introduction Multi-organ dysfunction (MOD) is a critical condition marked by the failure of two or more organ systems and is often associated with severe metabolic disturbances. One notable contributor is severe hypertriglyceridemia, defined as triglyceride (TG) levels ≥500 mg/dL (≥5.7 mmol/L), which significantly increases the risk of acute pancreatitis and is linked to elevated morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD).Conventional management strategies for hypertriglyceridemia, including lifestyle modification, fibrates, and omega-3 fatty acids, offer modest efficacy in reducing TG levels and cardiovascular risk. While elevated TG levels have long been associated with cardiovascular events, causality has been difficult to establish due to confounding metabolic interactions. However, a study by Varbo et al., published in the European Heart Journal, utilized Mendelian randomization to examine genetically elevated non-fasting TG levels in over 73,000 individuals. Their findings demonstrated a causal relationship between higher TG levels and increased risks of ischemic heart disease, ischemic stroke, and other vascular disorders, supporting the potential value of targeting TG in cardiovascular prevention. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 98 Figure 1 Multiorgan Dysfunction Syndrome(MODS) In parallel, non-alcoholic fatty liver disease (NAFLD) has emerged as a prevalent cause of chronic liver disease globally, closely linked with obesity, type 2 diabetes, and dyslipidemia. Despite its rising incidence, the metabolic pathways involved in NAFLD development remain incompletely understood. A comprehensive metabolomic study published in Cell Reports Medicine identified distinct metabolic signatures that precede the onset of NAFLD, integrating both observational and genetic data. These findings suggest the potential for early metabolic biomarkers to guide preventive and therapeutic strategies for NAFLD. Figure 2 Mechanisms Of Inflammation And Hypoxia Leading To Organ Injury And MODS Additionally, triglyceride-rich lipoproteins (TRLs) have gained attention as contributors to residual cardiovascular risk, even in patients achieving optimal low-density lipoprotein cholesterol (LDL-C) levels. These novel therapies have shown promise in substantially lowering TG levels and may help mitigate cardiovascular risk in high-risk populations. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 99 Together, these findings highlight the central role of triglycerides and related metabolic pathways in the development of both cardiovascular and hepatic diseases. Addressing elevated TG levels through targeted therapies may offer significant benefits in reducing multi-organ complications associated with metabolic dysfunction. The Aim of the study is to study and access clinical correlates of triglyceride levels and multi organ dysfunction in adults. The main objectives of this study is to evaluate the clinical correlation between triglyceride levels and dysfunction in multiple organ systems (hepatic, renal, cardiovascular, and endocrine), identify the demographic and lifestyle factors (age, BMI, alcohol/smoking history) associated with elevated triglyceride levels, assess the prevalence of comorbidities (e.g., diabetes, hypertension, thyroid disorders) in patients with hypertriglyceridemia, determine the relationship between triglyceride levels and glycemic control (FBS, PPBS, HbA1c) and correlate lipid subtypes (LDL, HDL, VLDL) with organ function markers. 2. Materials and methods • Study design: Cross-sectional , correlation study • Study population: 316 adults aged ≥ 25 years who attended general medicine Out-Patient Department and InPatient wards from ACS Medical College and Hospital, Chennai were included in the study. • Sample size: 316 2.1. Inclusion criteria: • Adults aged between ≥ 25 years who were attended the General medicine outpatient department and in-patient wards in the A.C.S Medical College and Hospital. • Availability of medicalrecords in the A.C.S Medical College and Hospital 2.2. Exclusion criteria • Adults who refused to give consent. • Pregnancy (OR) lactation • Known acute illness • Patients with malignancy or undergoing lipid lowering therapy 2.3. Data collection Data is collected by interviews by self-administered questionnaires that include demographic status ( age, sex, BMI ), medical history (hypertension, diabetes, cardiovascular disease, kidney disease, MASLD, Hyperlipidemia, hypothyroidism, hyperthyroidism etc.) Laboratory tests ( blood glucose test, hba1c, urine routine ) and organ specific assessments ( liver function test, renal function test, lipid profile ) are examined from the patient’s medical records. Informed consent was taken from adults who were attended general medicine Outpatient Department, In-Patient wards in ACS Medical College and Hospital. 2.4. Data analysis Descriptive statistics for baseline variables. Correlation analysis (Pearson or Spearman) between triglyceride levels and organ-specific parameters. ANOVA or t-test to compare mean triglyceride levels across diagnostic groups. p-value < 0.05 considered statistically significant. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 100 3. Result Figure 3 Distribution Of Age Among Study Population This distribution indicates that middle-aged and elderly individuals formed the bulk of the study group. Since age is an important factor influencing lipid metabolism. Figure 4 Distribution Of BMI Among Study Population The above Figure shows that 42% of participants were classified as obese, and 31% as overweight, indicating that a significant proportion (73%) were above the normal weight range. Only24% had normal BMI, and 3% were under weight. This high prevalence of overweight and obesity highlights a population at elevated risk for metabolic disorders, including hypertriglyceridemia. It reinforces the relevance of assessing BMI in relation to lipid profiles. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 101 Figure 5 Distribution of Triglyceride Levels Table 1 Comparison Of Triglyceride Levels Stratified By Personal History Personal history Triglycerides P value Mean Sd ALCOHOL 209.4 90.82 0.005 SMOKING 164.6 82.39 0.724 BOTH 206.5 79.8 0.019 NIL 147.76 74.947 0.097 In this table 1, the effect of personal habits like alcohol and smoking on triglyceride levels is analyzed. Alcohol users and individuals with both alcohol and smoking history had significantly higher triglyceride levels(p=0.005and0.019, respectively). Those with no history had comparatively lower levels, though the difference was not significant (p = 0.097). This indicates that alcohol consumption is a strong contributor to raised triglyceride levels in this cohort. Table 2 Correlation between Triglycerides Levels And Comorbidities Comorbidities Triglycerides Pvalue Mean SD DM 157.86 80.23 0.932 HTN 133.18 66.99 0.037 DM&HTN 158.10 74.72 0.949 HYPOTHYROIDISM 156 51.53 0.904 HYPERTHYROIDISM 135 2.82 0.001 DM&HYPOTHYROIDISM 124.57 46.68 0.109 HYPERLIPIDEMIA 200.5 65.15 0.011 BA 166.34 85.22 0.662 CAD 154.7 71.16 0.871 CKD 199 116.88 0.154 CVA 151.25 68.36 0.842 MASLD 297.42 108.7 0.015 World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 102 NIL 134.68 52.77 0.119 The statistical analysis presented in the table 2.2evaluates the association between various clinical diagnoses and triglyceride levels. Among the conditions studied, hyperlipidemia, hypertension (HTN), hyperthyroidism, and metabolic-associated steatotic liver disease (MASLD) showed statistically significant associations with elevated triglyceride levels, with pvaluesof0.011,0.037,0.001,and0.015,respectively Figure 6 Correlation Analysis Between Blood Glucose Parameters and Triglyceride Levels A statistically significant positive correlation was observed with postprandial blood sugar(PPBS)(r=0.254,p<0.001),indicatingthathighertriglyceridelevelsareassociatedwith elevated PPBS values. Fasting blood sugar (FBS) showed a weak, non-significant correlation (r= 0.0973, p = 0.085), and HbA1c had no significant correlation (r = 0.027, p = 0.629) Table 3 Correlation Analysis Between LFT Parameters and Triglyceride Levels Group Correlation(r) Pvalue TOTAL BILIRUBIN 0.1921 0.0006 DIRECTBILIRUBIN 0.2497 <0.001 INDIRECTBILIRUBIN 0.1861 0.0009 AST 0.2755 0.001 ALT 0.4347 <0.001 ALKALINEPHOSPHATASE 0.2798 <0.001 TOTALPROTEIN 0.0142 0.8014 ALBUMIN 0.0167 0.7669 These findingsuggest a strong association between elevated triglycerides and impaired liver function. Table 4 Correlation Analysis Between Lipid profiles and Triglyceride Levels GROUP CORRELATION(r) PVALUE TOTALCHOLESTEROL 0.4530 <0.001 HDL 0.044 0.434 World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 103 LDL 0.377 <0.001 VLDL 0.48 <0.001 CHOL:HDLRATIO 0.3070 <0.001 The above table 4 indicates significant positive correlations of triglycerides with total cholesterol (r = 0.4530), LDL (r = 0.377), VLDL (r = 0.48), and the cholesterol: HDL ratio(r=0.307), all with p values<0.001. However, HDL showed no significant correlation (r=0.044, p=0.434). This implies that high triglyceride levels are associated with an overall atherogenic lipid profile, especially increased VLDL and LDL, but not necessarily with reduced HDL. 4. Discussion According to Chen Gurevitz et al. (2024) in the study among U.S Adults, sHTG group - 70.3% had central obesity, 32.7% had diabetes, 21.6% had chronic kidney disease (CKD), 67.0% had metabolic dysfunction-associated steatotic liver disease (MASLD) and 10.6% had atherosclerotic cardiovascular disease (ASCVD with serum triglycerides mild, moderate and sever hypertriglyceridemia, 11.5%, 25.9% and 29.3% had multiorgan disease, respectively. Among the comorbidities of our study, diabetes mellitus was the most common condition (25%), followed closely by combined diabetes and hypertension (24%). Other notable conditions included BA (8%), CKD (6%), and hyperlipidemia (3%). A small portion (11%) had no known diagnosis. Hyperlipidemia, hypertension (htn), hyperthyroidism and MASLD showed statistically significant associations with elevated triglyceride levels with p-values of 0.011, 0.037, 0.001 and 0.015, respectively. MASLD had the highest mean triglyceride levels (297.42 mg/dl) indicating a strong link between this condition and hypertriglyceridemia. This shows that elevated triglycerides levels increase the risk of multi organ dysfunction in adults. Our study discussed about the correlation with respect to triglyceride levels and multiorgan dysfunction in adults. Overall, normal , mild and moderate triglyceride levels examined were 55%, 23% and 22% respectively. The prevalence of each comorbidity and multi organ dysfunction were higher among individuals with increasing triglyceride level Parhofer KG et al. (2019) noted that approximately 15% to 20% of patients visiting a medical practice are diagnosed with hypertriglyceridemia—frequently as an incidental finding in Jaross W, Assmann G, Bergmann S, et al. (1994). Given the increases in the prevalence of diabetes, metabolic syndrome, and obesity, the prevalence of hypertriglyceridemia is likely to increase too. Moreover, the severity of hypertriglyceridemia varies widely, and to date no uniform classification of the condition has been established. To further complicate the matter, triglyceride (TG) levels can show intra individual fluctuation. Most affected persons (80–90%) have moderately increased TG levels, i.e., between 150 mg/dL (1.7 mmol/L) and 400 mg/dL (4.6 mmol/L). In a small proportion of patients (approximately 15%), TG levels range between 400 mg/dL and 1000 mg/dL (4.6–11.4 mmol/L); occasionally, significantly higher levels are found (e1). In very rare cases, TG levels above 15 000 mg/dL (170 mmol/L) have been identified. Hypertriglyceridemia is causally linked to cardiovascular disease and pancreatitis. Our study highlights the abnormalities in the lipid profiles, indicating prevalence of multi organ dysfunction. 40% had mildly elevated total cholesterol levels and 35% had moderate elevations. A total of 75% had cholesterol values above the normal threshold (p-value < 0.001. These findings suggest a strong association between elevated triglycerides and impaired liver function. Bessembinders, K et al.(2011) has concluded that alcohol intake as well as other risk factors associated with HT were searched for in case records of 300 patients known to the laboratory to have had a TG level over 11.3 mmol/l. Excessive alcohol intake (over 210 g/week for males; over 140 g/week for females) was recorded for 24% of the total, and for 43% in the highest TG quartile. TG levels were significantly higher in the excessive drinkers (P < 0.001) and in patients with acute pancreatitis (P = 0.001). The incidence of pancreatitis in this cohort was 4% and limited to very high TG levels. Excessive alcohol consumption was recorded in a quarter of patients with severe hypertriglyceridemia. Alcohol users and individuals with both alcohol and smoking history had significantly higher triglyceride levels (p = 0.005 and 0.019, respectively). Those with no history had comparatively lower levels, though the difference was not significant (p = 0.097). This indicates that alcohol consumption is a strong contributor to raised triglyceride levels in this cohort. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(01), 097-105 104 Our study shows statistically significant positive correlation was observed with postprandial blood sugar (PPBS) (r = 0.254, p < 0.001), indicating that higher triglyceride levels are associated with elevated PPBS values which ultimately increases the risk for pancreatitis and other multi-organ dysfunctions. 5. Conclusion Elevated triglyceride-rich lipoproteins (TRLs) are critical therapeutic targets for reducing atherosclerotic cardiovascular disease (ASCVD) risk, with emerging inhibitors showing great promise. Our study confirms a significant correlation between high triglyceride levels and multi-organ dysfunction, including chronic kidney disease, MASLD, cardiovascular disease, diabetes, and hypertension, which is often exacerbated by substance use and sedentary behaviors. This underscores the necessity for proactive, multidisciplinary strategies that integrate lifestyle modifications, early detection, and personalized management to protect organ health, particularly in high-risk populations. As clinical trials advance, TRL-lowering therapies may provide an actionable pathway not only to reduce ASCVD but also to mitigate systemic organ impairment burdened by metabolic and lifestyle-related risks. Compliance with ethical standards Acknowledgments We extend our sincere thanks to medical staffs of ACS MEDICAL COLLEGE AND HOSPITAL in Chennai for their essential support in my research .special appreciation goes to DR.Kalpana devi for her support, as well as to my collegues .This study was conducted without external finding.The authors did not receive financial support or grants for this study. Disclosure of conflict of interest NO Conflicts Statement of ethical approval Ethical approval for this research was approved by Ethical committee in ACS medical college and hospital (Ref No.1366/2024/1EC/ACSMCH Dt.11.12.2.20). Informed consent was obtained from all individual participants included in the study. 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