Centres of Excellence -> Endocrinology and Diabetes -> Hyperlipidemia

Hyperlipidemia (high blood fat/high cholesterol)

Fats (lipids) are water-insoluble biochemical, organic compounds and are therefore transported in the blood circulation in combination with proteins, the so-called apoproteins. We distinguish between endogenous (created in the body) and exogenous lipids (introduced from the outside through food). According to the proportions of individual chemical compounds within the lipoprotein molecule, we distinguish between chylomicrons (made up mostly of triglycerides) and lipoproteins of different densities (made up mostly of cholesterol). Lipoproteins of different densities are divided into very low density lipoproteins (VLDL), low density lipoproteins (LDL), intermediate density lipoproteins (IDL) and high density lipoproteins (HDL). Lipoprotein levels, especially LDL increase with age. In men, they increase slightly more than in women, but after menopause they start to grow in women as well.

Disorders of lipoprotein metabolism

Disorders of lipoprotein metabolism are clinically manifested as disorders that include an increase in lipoprotein levels in the blood (hyperlipidemia).

In clinical practice, the division into hypertriglyceridemia, hypercholesterolemia and the combined form is most often used. The common feature of all hyperlipidemias is that they increase the risk of the occurrence and development of atherosclerosis and thus further complications in the sense of the occurrence of heart, brain and blood vessel diseases. Congenital (primary) hyperlipidemias are caused by mutations in various genes, while acquired (secondary) hyperlipidemias occur as a side effect of certain diseases or are caused by various external factors, such as an improper diet with a high proportion of fat and sugar, type 2 diabetes, insulin resistance, reduced thyroid function (hypothyroidism), liver and kidney diseases, etc.

Other diseases and conditions associated with elevated blood fat values

  • obesity
  • increased level of uric acid and gout
  • anorexia nervosa
  • lupus erythematosus
  • pregnancy
  • chronic alcohol consumption
  • treatment with diuretics (thiazide diuretics)
  • some types of contraceptives (oral contraceptives) and corticosteroids

Patients do not have any symptoms or notice accumulations of fat tissue under the skin in the area of the eyelids and tendons (xanthomas/xanthelasma), accumulation of fat in the liver (steatosis or fat infiltration of the liver) appears and later a series of complications such as inflammation of the liver, cirrhosis and vision complications angina pectoris, heart attack and stroke, aneurysm of the aorta, failure of kidney function and blockage of blood vessels, most often in the legs.

Diagnosis and treatment

The diagnosis is established by a specialist examination, laboratory tests, genetic testing and other laboratory-instrumental procedures, depending on the indication. The most important treatment measure is the strict implementation of a dietary regimen, treatment of accompanying diseases and the use of drugs whose purpose is to reduce the elevated level of fat in the blood.

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