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Item 5 - Lipid Profile & Dyslipoproteinemia

This document discusses lipid profiles and dyslipoproteinemia. It defines normal lipid levels and the objectives of lipid profiling. Primary dyslipoproteinemias are inherited disorders classified into types 1-5 based on increased lipid levels. Secondary dyslipoproteinemias result from other diseases and conditions like hepatic, renal or endocrine disorders, obesity, alcohol abuse, and certain drugs. Important causes of hypertriglyceridemia and hypercholesterolemia are also outlined.

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Fahmid Zarif
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29 views19 pages

Item 5 - Lipid Profile & Dyslipoproteinemia

This document discusses lipid profiles and dyslipoproteinemia. It defines normal lipid levels and the objectives of lipid profiling. Primary dyslipoproteinemias are inherited disorders classified into types 1-5 based on increased lipid levels. Secondary dyslipoproteinemias result from other diseases and conditions like hepatic, renal or endocrine disorders, obesity, alcohol abuse, and certain drugs. Important causes of hypertriglyceridemia and hypercholesterolemia are also outlined.

Uploaded by

Fahmid Zarif
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Lipid profile & dyslipoproteinemia

Serum lipid profile


S Total cholesterol 150 -200mg/dl , 4-6 mmol/L ,
S Triglyceride
male 50- 200mg/dl, 0.5-2.3mmol/L
female 40-150 mg/dl, 0.4- 1.6 mmol/L
( < 150 mg/dl – desirable )
HDL- C
> 40 mg/dl, 0.4 mmol/L
LDL-C

<100 mg/dl, 2.89 mmol/L , > 130 mg/dl high risk group
• Objective of lipid profile
1. Diagnosis of dislipidemia
2. Assessment of prognosis for a known case
3. Assessment of risk for atherosclerosis and
coronary artery disease(CAD)
• Preparation for lipid profile
1. 10- 12 hour fasting
2. Usual diet in previous 3 days , no dietary
change allowed
3. Usual activity in previous three days
4. Individual must be free from trauma, surgery,
acute infection, pregnancy
• Definition- group of disorder characterized by
abnormal plasma lipid and lipoprotein
concentration.
• Classified into following groups
1. primary disorder of plasma lipoprotein
2. Secondary disorder of plasma lipoprotein
1.Primary dyslipoproteinemia/dislipidemia

A primary dyslipoproteinemia is an inherited


disorder of lipoprotein metabolism.
It is of 2 types
a. primary hyperlipoproteinemia or primary
hyperlipidemia : increased level of lipid and
lipoprotein
1. familial hyperchylomicronemia - Type I
hyperlipidemia – lipoprotein lipase and apoC II
deficiency , CM increased, TG increased
2. Familial hypercholesterolemia- Type IIa
hyperlipidemia – decreased LDLR and apo B ,
increased LDL, cholesterol increased
3. Familial combined hyperlipidemia- Type II b
hyperlipidemia – increased apo B , increased LDL
and VLDL,TG and Cholesterol increased
4. Dysbetalipoproteinemia or Remnant removal
disease- Type III hyperlipidemia- decreased apo E,
increased CM and IDL, TG and cholesterol increased

5. Familial endogenous hypertriglyceridemia- Type


IV hyperlipidemia- increased VLDL , TG markedly
increase and( normal moderate increase in
cholesterol)

6. Familial Mixed hyperlipidemia- Type V


hyperlipidemia- increased CM, VLDL. TG and
cholesterol increased ,may be secondary
• b. primary hypolipoproteinemia
when plasma lipoprotein level is decreased due
to an inherent disorder of lipoprotein
metabolism . This can be classified as follows
1. Familial hypoalphalipoproteinemia –
decreased apoA1 and apoAII. HDL level is low
or absent , with normal T cholesterol and Tg
2. Abetalipoproteinemia – defect in apo B
synthesis. absence of CM, VLDL, LDL in
plasma
• 3. Hypobetalipoproteinemia : here apo B
deficiency with decreased level of CM, VLDL,
LDL.
2. Secondary dyslipoproteinemia
• The abnormal lipoprotein pattern secondary to
other disease is known as secondary or
acquired disorder. This type of disorder are as
follows
a.Secondary hyperlipidemia
1. Nutritional : excess calories in diet, excess
saturated fat, cholesterol
2. Hepatic disease : hepatitis, obstructive
jaundice
3. Obesity, alcohol abuse
4. diabetes mellitus
5. renal disease- chronic renal failure, nephrotic
syndrome
6. endocrine disorder- hypothyroidism. Cushing
syndrome
7. drugs – steroid oral contraceptives
B. secondary hypolipoproteinemia
Much less common than that of hyper
lipoproteinemia
1. PEM - kwashiorkor
2. Severe malabsorption
3. Severe liver disease
4. Malignancy, anorexia nervosa
5. Hyper thyroidism
Important cause of hypertriglyceridemia
1. DM
2. Chronic renal failure
3. Nephrotic syndrome
4. Obesity
5. Alcohol abuse
6. Oral contraceptive
7. Hormone replacement therapy
• Important cause of hypercholesterolemia
1. Hypothyroidism
2. Nephrotic syndrome
3. Chronic renal failure
4. DM
5. obstructive jaundice

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