What Is Dyslipidemia?
Dyslipidemia is a more common disease that is caused by abnormal metabolism of lipoproteins in the human body, mainly including total cholesterol and low-density lipoprotein cholesterol, elevated triglycerides, and / or reduced high-density lipoprotein cholesterol. Dyslipidemia is one of the important factors leading to atherosclerosis, and it is an independent risk factor for coronary heart disease and ischemic stroke. The incidence of dyslipidemia is high in our country, and there is a gradual upward trend, which is closely related to the obvious improvement in the living standards of our people and changes in dietary habits.
Basic Information
- English name
- dyslipidemia
- Visiting department
- cardiology
- Common symptoms
- "Xanthomas, atherosclerosis, coronary heart disease, peripheral vascular disease, etc."
- Contagious
- no
Causes of Dyslipidemia
- Dyslipidemia is due to secondary dyslipidemia due to systemic diseases, and most of them are primary dyslipidemia caused by genetic defects or interaction with environmental factors.
- Genetic factor
- Primary dyslipidemia is caused by genetic defects or interaction with environmental factors.
- 2. Lifestyle
- Including bad eating habits such as overeating, drinking, partial eating, irregular eating habits, lack of physical activity, mental stress, irregular life, etc.
- 3. Drug effect
- Long-term use of certain drugs, such as thiazide diuretics, beta blockers, adrenal cortex hormones, oral contraceptives, etc.
- 4. Secondary factors
- Caused by various diseases, such as diabetes, hypothyroidism, nephrotic syndrome, kidney transplantation, biliary obstruction, etc.
Classification and typing of dyslipidemia
- Classification
- (1) Secondary hyperlipidemia refers to abnormal blood lipids caused by systemic diseases. The systemic diseases that can cause blood lipids are mainly diabetes, nephrotic syndrome, hypothyroidism, and other diseases include renal failure, liver disease, systemic lupus erythematosus, glycogen accumulation, myeloma, steatosis, acute Porphyria, polycystic ovary syndrome, etc. In addition, certain drugs such as diuretics, beta blockers, glucocorticoids, etc. may also cause secondary elevated blood lipids.
- (2) Primary hyperlipidemia After excluding secondary hyperlipidemia, it can be diagnosed as primary hyperlipidemia. It is known that part of the primary hyperlipidemia is due to a congenital genetic defect, while the etiology of the other part of the primary hyperlipidemia is unclear.
- 2.Type
- (1) Classification of hyperlipoproteinemia The World Health Organization (WHO) has developed a classification of hyperlipoproteinemia, which is divided into 6 types, such as type I, IIa, IIb, III, IV, and V. This typing method is of great help in guiding clinical diagnosis and treatment of hyperlipidemia, but there are also shortcomings. The most obvious disadvantage is that it is too complicated.
- (2) Clinical typing From a practical point of view, simple clinical typing of dyslipidemia can be performed. There are mainly hypercholesterolemia with elevated serum cholesterol, hypertriglyceridemia with elevated serum triglyceride alone, and mixed hyperlipidemia with elevated serum cholesterol and triglyceride. In addition, there is low-high-density lipoproteinemia with low serum high-density lipoprotein cholesterol levels.
- (3) Genotyping With the rapid development of molecular biology, people's understanding of hyperlipidemia has gradually deepened to the level of genes. It has been found that a significant proportion of patients with hyperlipidemia have a single or multiple genetic defects. Because hyperlipidemia caused by genetic defects is mostly family-aggregated and has a clear genetic tendency, it is often referred to clinically as familial hyperlipidemia.
Clinical manifestations of dyslipidemia
- Yellow tumor
- Xanthomas caused by lipid deposition in the dermis. Patients can develop flat yellow tumors, palm wrinkle yellow tumors, tendon yellow tumors, and nodular xanthomas.
- 2. Symptoms of coronary heart disease and peripheral vascular disease
- Atherosclerosis caused by the deposition of lipids on vascular endothelium causes coronary heart disease and peripheral vascular disease.
- Because the incidence of xanthomas is not very high when dyslipidemia occurs, and the occurrence and development of atherosclerosis takes a long time, most patients with dyslipidemia do not find any symptoms and abnormal signs. Patients with dyslipidemia are often found during blood biochemical tests (determining blood cholesterol and triglycerides).
Dyslipidemia
- Physical examination
- (1) Measure height, waist, and abdominal circumference, and calculate body mass index and waist-hip ratio.
- (2) Observe the patient for yellow tumors and palpation for liver and splenomegaly. Examine the patient's joints and confirm the presence or absence of migratory polyarthritis in conjunction with the medical history.
- 2. Laboratory inspection
- There are many clinical tests for blood lipids. The basic tests are total cholesterol, triglycerides, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol.
- (1) Plasma appearance inspection The content of chylomicrons (mainly containing triglycerides) in the plasma can be judged.
- (2) Lipoprotein electrophoresis method can be divided into chylomicrons, pre-, and four lipoprotein zones.
- (3) Ultracentrifugation method It can distinguish chylomicron, very low density lipoprotein, intermediate density lipoprotein, low density lipoprotein and high density lipoprotein.
- (4) Measurements of blood cholesterol and triglycerides should be carried out 9 to 12 hours after fasting.
- 3. Liver and kidney function, urine analysis, etc.
- The purpose is to rule out secondary dyslipidemia.
Dyslipidemia diagnosis
- Laboratory test results are the main basis for diagnosis of abnormal lipid metabolism. The "Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults" sets a new standard for blood lipids based on the actual situation of Chinese people. Cholesterol: <200 mg / dL is the appropriate range, and between 200 and 239 mg / dL is the marginal rise, 240 mg Shares rise. Low-density lipoprotein: <130 mg parts per liter is the appropriate range, between 130 and 159 mg / dL is marginal elevation, and 160 mg / dL is elevated. Triglyceride: 150 mg / dL is the appropriate range, 150 to 190 mg / dL is the marginal rise, and 200 mg / dL is the elevation. High-density lipoprotein: men should not be <40 mg / dl, women should not be <50 mg dl.
Dyslipidemia treatment
- Treatment principle
- (1) Comprehensive evaluation based on whether there is a coronary heart disease or coronary heart disease and other cardiovascular risks and cardiovascular risk factors, combined with blood lipid levels, to determine the treatment measures and target blood lipid levels.
- (2) Diet therapy and lifestyle improvement are the basic measures for the treatment of dyslipidemia. Regardless of whether or not to perform lipid-lowering therapy, you must adhere to diet control and lifestyle improvement.
- (3) According to the type of dyslipidemia and the purpose to be treated, select appropriate lipid-lowering drugs. Regular monitoring of lipid-lowering efficacy and adverse drug reactions is required.
- (4) When deciding to use drugs for lipid-lowering treatment, it is necessary to fully understand the patients with coronary heart disease and the associated risk factors. When performing lipid-lowering treatment, lowering LDL cholesterol should be the primary goal.
- 2. Therapeutic lifestyle changes
- (1) Reduce intake of saturated fatty acids and cholesterol.
- (2) Choose foods that can lower low-density lipoprotein cholesterol (such as plant sterols and soluble fiber).
- (3) Lose weight.
- (4) Increase regular physical activity.
- (5) Take measures against other cardiovascular risk factors such as quitting smoking and limiting salt to reduce blood pressure.
- 3. Drug treatment
- (1) statins statins can significantly reduce total cholesterol and low-density lipoprotein cholesterol, but also lower triglyceride levels and slightly increase high-density lipoprotein cholesterol. In addition, statins may also have anti-inflammatory and vascular endothelial functions. Clinical studies in the past two decades have shown that statins are very important drugs for the prevention and treatment of hypercholesterolemia and atherosclerotic diseases. Commonly used statins are: lovastatin, simvastatin, pravastatin, fluvastatin, and atorvastatin.
- In addition, the domestic traditional Chinese medicine Xuezhikang capsules contain a variety of natural statins, mainly lovastatin.
- (2) Fibrates Fibrate drugs that can be selected clinically include: fenofibrate, micronized capsules, benzabate, and gemfibrozil.
- (3) Niacin Sustained-release tablets.
- (4) Cholic acid sequestrants Colesmide and Colestipol.
- (5) Cholesterol absorption inhibitor Ezetimibe
- (6) Other lipid-lowering drugs Probucol, n-3 fatty acids.
- 4. Other measures
- Surgery, dialysis, and gene therapy.
Prevention of Dyslipidemia
- Reasonable diet
- Promote light diets and limit high-fat, high-cholesterol diets, such as animal brains, egg yolks, chicken liver, butter, etc. Do not eat sweets and snacks, eat more vegetables and fruits, a low-salt diet, and soybean oil, peanut oil, and vegetable oil , Sesame oil, etc.
- 2. Quit smoking and limit alcohol
- Nicotine in cigarettes can cause peripheral blood vessels to contract and increase myocardial stress, increase blood pressure, and cause angina pectoris. Inappropriate drinking can reduce heart function and damage the gastrointestinal tract, liver, nervous system, and endocrine system.
- 3. Proper exercise
- Adhere to proper exercise, such as jogging, Wu Qin Xi, Tai Chi, table tennis, and disco for the elderly. Usually participate in physical labor often, to control weight gain.
- 4. Moderate amount of tea
- Catechin contained in tea has the effect of enhancing vascular flexibility, elasticity and permeability, and can prevent vascular sclerosis. Theophylline and caffeine in tea can stimulate the spirit, promote blood circulation, reduce fatigue and have a diuretic effect. Moderate drinking tea can eliminate greasy diet and lose weight.