Obesity Management Hyperlipidemia (Cholesterol, TGL, LDL,HDL, VDRL)

Obesity Management Hyperlipidemia (Cholesterol, TGL, LDL,HDL, VDRL)

Description ;-

Hyperlipidemia is a heterogeneous group of disorders characterized by an excess of lipids in the bloodstream. These lipids include cholesterol, cholesterol esters, phospholipids, and triglycerides. Lipids are transported in the blood as large 'lipoproteins'

Lipoproteins are divided into four major classes, based on density :-

a. Very low-density lipoproteins (VLDL).

b. Intermediate-density lipoproteins (IDL).

c. Low-density lipoproteins (LDL).

d. High-density lipoproteins (HDL).

MANAGEMENT :-

01. Drug therapy.

02. Lifestyle Modification.

03. Behavioral modification. 

04. Nutritional Treatment.

05. Exercise Therapy.

06. Herbal Therapy.

KNOW MORE :- 

01. Primary hyperlipidemias are probably genetically based, but the genetic defects are known for only a minority of patients.

02. Secondary hyperlipidemia may result from diseases such as diabetes, thyroid disease, renal disorders, liver disorders, and Cushing's syndrome, as well as obesity, alcohol consumption, estrogen administration, and other drug-associated changes in lipid metabolism.

03. Hyperlipidemia is a major, modifiable risk factor for atherosclerosis and cardiovascular disease, including coronary heart disease; this is true both of disorders involving hypercholesterolemia and hypertriglyceridemia.

Synonyms :-

01. Hypercholesterolemia

02. Hypertriglyceridemia

03. Hyperlipoproteinemia

04. Dyslipidemia

05. High serum cholesterol

Key points :-

A. CHypercholesterolemia, regardless of cause, is a major modifiable risk factor for coronary artery disease

B. Hyperlipidemia is usually asymptomatic until serum lipid levels are severely elevated, and well beyond the range at which cardiovascular morbidity and mortality are increased

C. Identification of patients who would benefit from lipid-lowering therapy, therefore, depends on screening of adults and certain children for high serum lipid levels, as well as obtaining a careful history to detect risk factors that suggest the patient would benefit from lipid-lowering therapy, even if serum lipid levels are 'normal'

D. Effective and well-tolerated therapy for lowering LDL cholesterol (LDL-C) is now available, and should receive widespread application

E. Epidemiologic studies predict that for each 1% reduction in the level of LDL-C, there is a 1% to 1.5% reduction in the risk of major cardiovascular events

F. Treatment goals for lipid-lowering therapy depend on risk stratification of the patient to identify appropriate lipid level 'targets'

G. Lifestyle modifications, such as weight loss, exercise, and dietary changes, are also key in long-term management.

Hypertriglyceridemia :-

01. Drug therapy for elevated triglycerides is presently available, and new drugs are being developed.

02. Contrary to widespread belief, hypertriglyceridemia is also a modifiable risk factor for cardiovascular disease.

Cardinal features ;-

a. Hyperlipidemia is a group of disorders characterized by an excess of serum cholesterol, especially excess LDL-C and/or excess triglycerides

b. Hypercholesterolemia is generally asymptomatic

c. Hypertriglyceridemia is generally asymptomatic until triglyceride levels are sustained above 1000 mg/dL - symptoms then include dermatologic manifestations, such as eruptive xanthomas, and gastrointestinal manifestations, such as pancreatitis

d. Hyperlipidemias are most often genetically determined, but can be caused or amplified by abnormal diet, drugs, and certain disease conditions.

e. Drugs associated with hyperlipidemias include immunosuppressive therapy, thiazide diuretics, progestin's, retinoid, anabolic steroids, glucocorticoids, HIV protease inhibitors, alcohol, retinoic acid, and beta-blockers

f. Diseases associated with secondary hyperlipidemias include diabetes mellitus (type I and type II), hypothyroidism, Cushing's syndrome, chronic kidney disease, nephritic syndrome, and cholestatic disorders

g. Hyperlipidemia is a major modifiable risk factor for atherosclerosis and cardiovascular disease, including coronary heart disease

h. Treatment goals are based on absolute serum levels of lipids, and/or risk stratification of patients - more aggressive treatment to achieve lower lipid target levels is indicated in higher-risk patients

i. Evidence shows that effective therapy to lower serum LDL-C is associated with dramatic benefits in terms of short-term morbidity and mortality in patients with coronary artery disease, and long-term morbidity and mortality even in low-risk patients

A. Common causes :-Familial combined hypercholesterolemia is the most common primary lipid disorder, characterized by moderate elevation of plasma triglycerides and cholesterol and reduced plasma HDL-C

B. Familial hypertriglyceridemia.

Rare causes :-

Hypercholesterolemia :-

01. Familial hypercholesterolemia with raised cholesterol

02. Familial dysbetalipoproteinemia (Type III hyperlipoproteinemia)

03 Familial defective apolipoprotein (Apo) B100

04. Apo AI deficiency

05. Autosomal recessive hypercholesterolemia

06. Tangier disease

07. Wolman disease

08. Sitosterolemia

09. Remnant hyperlipoproteinemia with marked combined hyperlipidemia

10. Polygenic hypercholesterolemia

11. Lecithin:cholesterol acyltransferase deficiency.

Hypertriglyceridemia :-

Lipoprotein lipase deficiency (familial chylomicronemia syndrome, type I hyperlipoproteinemia) with extremely raised triglycerides and moderately raised cholesterol. 

Serious causes ;-

A. Homozygous familial hypercholesterolemia.

B. Contributory or predisposing factors

C. Other diseases that may contribute to hyperlipidemia include:

D. Insulin-dependent diabetes mellitus

E. Non-insulin dependent diabetes mellitus

F. Hypothyroidism

G. Cushing's syndrome

H. Renal failure and nephrotic syndrome

I. Cholestatic disorders

J. Dysproteinemias.

Drugs associated with hyperlipidemia include :-

01. Anabolic steroids

02. Retinoids

03. Birth control pills and estrogens

04. Corticosteroids

05. Thiazide diuretics

06. Protease inhibitors

07. Beta-blockers.

Dietary causes include :-

A. Fat intake per total calories greater than 40%

B. Saturated fat intake per total calories greater than 10%

C. Cholesterol intake greater than 300 mg per day

D. Habitual excessive alcohol use.

Lifestyle contributing factors include :-

01. Habitual excessive alcohol use

02. Obesity

03. Lack of exercise.

Always Co-ordinate with Respective Cardiologist/ Clinical Nutritionist / Medical Professional.

AFTER TRANSFORMATION