Dyslipidemia

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Retrieved
2021-01-18
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Dyslipidemia is an abnormal amount of lipids (e.g. triglycerides, cholesterol and/or fat phospholipids) in the blood. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood. This is often due to diet and lifestyle. Prolonged elevation of insulin levels can also lead to dyslipidemia. Likewise, increased levels of O-GlcNAc transferase (OGT) may cause dyslipidemia.

Types

Increases Decreases
Lipid
  • Hyperlipidemia: lipids
    • Hypercholesterolemia: cholesterol. Familial hypercholesterolemia is a specific form of hypercholesterolemia due to a defect on chromosome 19 (19p13.1-13.3).
    • Hyperglyceridemia: glycerides
      • Hypertriglyceridemia: triglycerides
  • Hypolipidemia
    • Hypocholesterolemia: cholesterol
Lipoprotein
  • Hyperlipoproteinemia: lipoproteins (usually LDL unless otherwise specified)
    • Honemia: chylomicrons
  • Hypolipoproteinemia: lipoproteins
    • Abetalipoproteinemia: beta lipoproteins
    • Tangier disease: high density lipoprotein
Both
  • Combined hyperlipidemia: both LDL and triglycerides

Diagnosis

Classification

Physicians and basic researchers classify dyslipidemias in two distinct ways:

  • Presentation in the body (including the specific type of lipid that is increased)
  • Underlying cause for the condition (genetic, or secondary to another condition). This classification can be problematic, because most conditions involve the intersection of genetics and lifestyle issues. However, there are a few well-defined genetic conditions that are usually easy to identify.

Fredrickson Classification:

Phenotype I IIa IIb III IV V
Elevated Lipoprotein Chylomicron LDL LDL and VLDL IDL VLDL VLDL and chylomicrons

Screening

Testing the general population under the age of 40 without symptoms is of unclear benefit.

Management

Statins

Fibrates

Ezetimibe