Lipidemias


Risk

  • Prevalence in USA: 13.1% in people >20 y.

  • Prevalence highest among Hispanics.

  • Cigarette smoking is a risk factor.

  • Incidence highest among men ≥45 y and women ≥55 y.

  • Htn is a risk factor.

  • Low HDL (<40 mg/dL) is a risk factor.

  • Family Hx of premature CHD in first degree relative (male <55 y or female <65 y) is a risk factor.

Perioperative Risks

  • Pancreatitis with hypertriglyceridemia

  • Stroke and transient ischemic attacks

  • Myocardial ischemia, infarction, CHF

Worry About

  • Angina of increasing frequency or severity and new-onset angina

  • Peripheral atherosclerosis

  • Worsening or new-onset CHF

  • TIAs

Overview

  • Hypertriglyceridemia, hypercholesterolemia, lipodystrophy: Köbberling-Dunnigan syndrome (familial lipodystrophy of limbs and trunk, autosomal dominant) may lead to macrosomia; familial generalized lipodystrophy (Berardinelli-Seip syndrome: autosomal recessive) leads to macrosomia.

  • Hypolipidemia: LDL deficiency (autosomal recessive abetalipoproteinemia, autosomal dominant familial hypobetalipoproteinemia); normotriglyceridemic abetalipoproteinemia (LDL absent); autosomal recessive Tangier disease (severe deficiency of HDL); secondary to cancer, myeloproliferative disorders, liver failure familial hypoalphalipoproteinemia (HDL deficiency).

Etiology

  • Autosomal dominant or recessive inheritance

  • Secondary to systemic illness (i.e., primary hypothyroidism, nephrotic syndrome, and extrahepatic obstruction of bile)

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