Hyperlipidemia, also known as hyperlipidemia or dyslipidemia, refers to an increase in the levels of cholesterol (CH), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) in the serum, while the level of high-density lipoprotein cholesterol (HDL-C) decreases. Genetic factors, unhealthy lifestyle, diabetes and other factors may cause hyperlipidemia. Hyperlipidemia can lead to coronary heart disease and other atherosclerotic cardiovascular diseases (ASCVD), and increase the risk of tumors. After active comprehensive treatment, the prognosis of this disease is good.
Clinical classification
According to the classification of elevated lipoproteins
- HyperCHemia: Elevated total cholesterol, normal triglycerides, and normal high-density lipoprotein cholesterol.
- Hypertriglyceridemia: Normal total cholesterol, elevated triglycerides, and normal high-density lipoprotein cholesterol.
- Mixed hyperlipidemia: both total cholesterol and triglycerides are elevated, while high-density lipoprotein cholesterol is normal.
- HypoHDL-Cemia: Normal total cholesterol, normal triglycerides, and decreased high-density lipoprotein cholesterol.
epidemiology
contagious
Non infectious.
incidence rate
This disease is common and frequently occurring. The 2018 national survey results showed that the total incidence of dyslipidemia in adults over 18 years old was 35.6%.
incidence trend
In recent years, the incidence of hyperlipidemia has been on the rise.
Easy to reach people
- This disease can be seen in people of different ages and genders, and patients with obvious dyslipidemia often have a family history. Blood lipid levels increase with age, reaching their peak at 50-60 years old, and then tend to stabilize or decrease.
- The blood lipid levels of middle-aged and young women are lower than those of men, but significantly increase after menopause, often higher than those of men of the same age.
Causes
Overview
Factors such as lipid sources, lipoprotein synthesis, abnormalities in key enzymes in the metabolic process, or disorders in receptor pathways in the degradation process can all lead to dyslipidemia. According to the cause of the disease, hyperlipidemia can be divided into primary and secondary.
Basic Cause
1. Primary dyslipidemia
Primary dyslipidemia accounts for the vast majority of dyslipidemia, and the cause is unknown. It is the result of the interaction between genetic and environmental factors. Most primary dyslipidemias have single or multiple gene mutations, and environmental factors include poor eating habits, lack of exercise, obesity, age, smoking and alcoholism.
2. Secondary dyslipidemia
(1) Hypothyroidism, Cushing’s syndrome, liver and kidney diseases, systemic lupus erythematosus, myeloma, polycystic ovary syndrome, etc. can affect the synthesis, transport or metabolism of lipids or lipoproteins, causing secondary dyslipidemia.
(2) Excessive drinking can cause secondary dyslipidemia.
(3) Long-term use of certain drugs such as thiazide diuretics, beta-blockers, glucocorticoids, and some anti-tumor drugs can cause secondary dyslipidemia.
(4) Estrogen deficiency can also cause secondary dyslipidemia.
Symptoms
Overview
Hyperlipidemia generally has no obvious symptoms and is often found during physical examinations or when complications occur. Some patients may experience symptoms such as xanthomas, premature corneal rings, fundus changes, etc. Hyperlipidemia may also cause diseases such as atherosclerosis, arthritis, acute pancreatitis, and diabetes.
Typical symptoms
1. Xanthomas
Xanthomas are abnormal localized skin protrusions caused by localized lipid deposition. They may be yellow, orange, or brownish red in color and are often in the form of nodules, plaques, or papules with a soft texture. They are most commonly found around the eyelids.
2. Early-onset corneal ring
The outer edge of the cornea appears as a grayish white or white cloudy area, which is caused by corneal lipid deposition and often occurs in people under 40 years old.
3. Changes in fundus
Severe hypertriglyceridemia may cause lipid-dense fundus changes.
Associated symptoms
Long-term hyperlipidemia can lead to a series of manifestations of accompanying diseases:
1. When atherosclerosis occurs, symptoms such as chest tightness, chest pain, dizziness, and claudication may occur.
2. When diabetes is caused, symptoms such as polydipsia and polyuria may occur.
3. When combined with multiple metabolic disorders, patients may become obese.
complication
1. Atherosclerosis
Lipid deposition under the endothelium of blood vessels causes atherosclerosis, leading to cardiovascular and peripheral vascular diseases. Some familial dyslipidemia can cause coronary heart disease and even myocardial infarction before puberty.
2. Arthritis
Severe hyperCHemia may cause migratory polyarthritis.
3. Acute pancreatitis
Severe hypertriglyceridemia (＞10mmol/L) can form emboli that block pancreatic capillaries and cause acute pancreatitis.
4. Diabetes
Hyperlipidemia can lead to impaired glucose tolerance and diabetes through lipotoxicity.