Hyperlipemias

"Its origin comes from food and synthesis by the liver".

DR. CAMILO SILVA FROJÁN
SPECIALIST. ENDOCRINOLOGY AND NUTRITION DEPARTMENT

Hyperlipemias is a group of alterations in fat metabolism that is characterized by an increase in one or more lipid fractions in the blood.

The two most important types of circulating fats are triglycerides and cholesterol.

They can be classified into hypertriglyceridemias, or increased concentration of triglycerides; hypercholesterolemias, and mixed hyperlipemias in which both cholesterol and triglycerides are increased.

With a proper diet, physical exercise and adequate weight. If these measures were not sufficient, drugs would have to be added.

The most widely used are statins, which in addition to reducing cholesterol have other beneficial effects on atherosclerosis plaques.

It has been proven that in addition to lowering cholesterol, the Mediterranean diet improves cardiovascular health more than diets that only lower cholesterol. Its main components are: vegetables, fish, olive oil and nuts.

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What are the symptoms of hyperlipemias?

In most cases the elevation of fats in the blood does not produce acute symptoms, so a blood test is necessary to make the diagnosis.

When exceptionally high triglyceride numbers are present, they can produce episodes of abdominal pain due to pancreatitis, enlargement of the liver and spleen, and the appearance of fat rashes on the skin called eruptive xanthomatosis.

If the increase in cholesterol and/or triglycerides is chronic, it constitutes a risk factor for the development of arteriosclerosis. Therefore, especially hypercholesterolemias, can lead to the development of coronary insufficiency (angina pectoris, myocardial infarction), cerebral vascular accidents and circulation disorders of the lower extremities.

The alteration of the large vessels occurs as a result of the accumulation of cholesterol in the so-called foam cells, which constitute the basis for the development of atheroma plaque, which is the basic element in atherosclerosis. The atheroma plaque progressively obstructs the passage of blood, favoring a scarce supply of oxygen to the tissues or ischemia that can lead to irreversible lesions.

Hypercholesterolemias produce cholesterol deposits in the skin and tendons, called xanthomas. When they occur in the eyelids they are called xanthelasmas.

In some patients hypertriglyceridemia is associated with a decrease in HDL cholesterol, and other complications such as high blood pressure, diabetes mellitus, obesity and hyperuricemia, forming the so-called metabolic syndrome that carries a high risk of cardiovascular disease.

What are the most common symptoms?

  • Abdominal pain.
  • Enlargement of the liver and spleen.
  • Eruptive Xanthomatosis.
  • Circulation disorders in the lower extremities.

Do you have any of these symptoms?

You may have hyperlipemia

What are the causes of hyperlipemia?

Hyperlipemias is classified into primary, when it is due to an alteration of the fat metabolism itself, and secondary, when it occurs as a result of another disease or the taking of certain medications.

Primary hyperlipemias are transmitted hereditarily with greater or lesser penetrance, which makes it necessary to evaluate this possibility when there is a family history of hyperlipemia.

To this type belong family hypercholesterolemia, family hypertriglyceridemia and family combined hyperlipemia.

There are many diseases that occur with hyperlipemia such as decompensated diabetes mellitus, hypothyroidism, nephrotic syndrome, obstructive jaundice, anorexia nervosa, lupus erythematosus, alcoholism, treatment with gestagens, beta blockers, etc.

What is your prognosis?

Primary hyperlipemias require chronic treatment for life.

They occur at any age. The primary hyperlipemias can be manifested at very early ages.

Secondary hyperlipemias can disappear once the cause is eliminated. However, it is common that in hyperlipemias that require drug treatment should be administered chronically.

The effectiveness of treatment of hyperlipemias on the evolution of atheroma plaques has been demonstrated

How is hyperlipemia diagnosed?

<p>&nbsp;Imagen Laboratorio de Bioquimica</p>

To establish the diagnosis of hyperlipemias is necessary to perform a blood draw with a minimum fasting of 12 hours. It is equally important to take into account the possible interference of previous medications or diseases such as infections or surgical interventions, which in themselves alter the metabolism of fats.

Total cholesterol and triglyceride concentrations should be less than 200 mg/dl. (milligrams per deciliter) and that of HDL cholesterol above 35 mg/dl. Once elevated lipid levels are observed, the possible cause should be investigated to establish the existence of secondary or primary hyperlipemia.

In specific cases, a study of the apoproteins (transport proteins) involved can be carried out.

How is hyperlipemia treated?

People with hyperlipemia should follow an adequate dietary treatment based on the restriction of saturated or animal fats below 10 percent of the total caloric content and cholesterol below 300 mg. daily.

Skimmed milk products should be taken, fresh cheese should be eaten instead of cured, bakery products should not be consumed, meat and pork products should be avoided, as well as butter, margarine and cream.

In addition, it is necessary to achieve a weight figure as close to normal as possible, avoiding both overweight or obesity and thinness. It is very convenient to do regular physical exercise that helps to improve the lipidic metabolism.

If after the application of these hygienic-dietary measures for a minimum period of three months, the hyperlipemia persists, it is necessary to resort to pharmacological treatment, in addition to continuing with the exercise and the feeding rules.

When the problem is a hypertriglyceridemia, fibric acid derivatives or fibrates are the most effective drugs. In this group, gemfibrocyl, bezafibrate and alufibrate stand out.

In case of hypercholesterolemia the most effective medication is statins such as lovastatin, simvastatin or atorvastatin, which can be combined with cholestyramine type resins if they are not effective on their own.

Combined hyperlipemias can be treated with fibrates, statins, or a combination of both. Other useful drugs are nicotinic acid, which can produce skin alterations and worsen diabetes, and probucol.

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Endocrinology and Nutrition of the
of the Clínica Universidad de Navarra

The Department is organized into care units with specialists totally dedicated to the study, diagnosis and treatment of this type of disease.

We work with established protocols, which ensure that all diagnostic tests to be performed are done in the shortest time possible and that the most appropriate treatment is started as soon as possible in each case.

Organized in care units

  • Obesity Area.
  • Diabetes Unit.
  • Thyroid and Parathyroid Disease Unit.
  • Osteoporosis Unit
  • Other diseases: e.g. Cushing's syndrome.
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Why at the Clinica?

  • European Center of Excellence in the diagnosis and treatment of Obesity.
  • Team of specialized nurses at the Day Hospital of Endocrinology and Nutrition.
  • We have a Metabolic Research Laboratory of international prestige.

Our team of professionals

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