Patients Care

DYSLIPIDEMIA

Dyslipidemia is a disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency. Dyslipidemias may be manifested by elevation of the total cholesterol, the "bad" low-density lipoprotein (LDL) cholesterol and the triglyceride concentrations and a decrease in the "good" high-density lipoprotein (HDL) cholesterol concentration in the blood.

Causes

  • Dyslipidemia comes under consideration in many situations including diabetes, a common cause of lipidemia. For adults with diabetes, it has been recommended that the levels of LDL, HDL and total cholesterol and triglyceride be measured every year.
  • Dyslipidemia is a disruption in the amount of lipids in the blood. In western societies, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood, often due to diet and lifestyle.
  • The prolonged elevation of insulin levels can lead to dyslipidemia.
  • Secondary causes contribute to most cases of dyslipidemia in adults. The most important secondary cause in developed countries is lifestyle with excessive dietary intake of saturated fat and cholesterol.
  • Other common secondary causes include diabetes mellitus, alcohol overuse, chronic kidney disease, hypothyroidism, liver diseases and drugs.
  • Diabetes is an especially significant secondary cause, patients with type 2 diabetes are especially at risk. The combination may be a consequence of obesity, poor control of diabetes, or both. Diabetic dyslipidemia is often exacerbated by the increased caloric intake and physical inactivity that characterize the lifestyles of some patients with type 2 diabetes.
  • Women with diabetes may be at special risk for cardiac diseases.
  • Hyperlipidemia is a common and treatable cause of atherosclerosis. Atherosclerosis is the most common cause of death in both men and women in developed countries. The goal is to diagnose and retard or reverse atherosclerosis while it is still in a silent early state before complications occur.

Sign & Symptoms

  • Dyslipidemia itself usually causes no symptoms but can lead to symptomatic vascular disease, including coronary artery disease and peripheral arterial disease.

Management

  • Dyslipidemia is diagnosed by measuring serum lipids. Routine measurements (lipid profile) include total cholesterol (TC), Triglycerides, HDL-cholesterol and LDL-cholesterol.
  • Patients with premature atherosclerotic cardiovascular disease, cardiovascular disease with normal or near-normal lipid levels, or high LDL levels refractory to drug therapy should get C-reactive protein and homocysteine measurement done.
  • Treatment includes life style changes. For high LDL Cholesterol statins are used and sometimes bile acid sequestrants with other measures. For high triglycerides or low HDL Cholesterol Niacin fibrates etc are used.