Definition and Overview
Lipids, more commonly known as fats, are essential to the body. They are stored energy that the body taps into when normal energy sources are scarce. However, they can cause a problem if the body is unable to break them down. This results in too much fat in the blood. This condition is called hyperlipidemia.
Fats are composed of cholesterol, triglycerides, and free fatty acids. They do not mix with water very well. In order for the body to transport fats through the blood, it combines the fat with lipoproteins. Too much lipoprotein in the blood is referred to as hyperlipoproteinemia (HLP).
HLP increases the risk of arterial blockage. This is the primary cause of heart disease and stroke. It also increases the risk of other health problems, including kidney disease.
Causes of the Condition
HLP can be primary or secondary. It is the former if caused by genetic factors that cause the body to produce high amounts of lipoproteins. The latter, on the other hand, develops due to lifestyle factors and certain diseases. Patients who are prone to this condition are those with a sedentary lifestyle, who are obese or overweight, and eat an unhealthy diet. Meanwhile, diseases that can increase the risk of the condition include diabetes, pancreatitis, and hypothyroidism. Drugs, such as steroids and contraceptives, can also cause HLP.
Primary HLP has five subtypes. Type 1 is inherited. It affects the body’s normal process of breaking down fats. As a result, there are more fats in the blood than the body requires. Type 2 is also inherited. With this type, more bad cholesterol and very-low-density lipoproteins (VLDL) are present in the blood. Type 3 subtype is marked by high levels of blood cholesterol and triglycerides. Type 4 is marked by high blood levels of triglycerides. High levels of LDL and/or VLDL indicate the presence of type 5 subtype.
The symptoms of HLP depend on the type. Type 1 is often associated with abdominal pain and enlargement of the liver or spleen. Other symptoms are yellow lumps on the skin and increased blood chylomicron levels.
Type 2 HLP causes high levels of beta-lipoproteins and serum cholesterol. Patients with this condition have xanthomas. These are growths of fats on the skin. Patients also often have a history of heart disease in the family.
Patients with type 3 HLP may not display symptoms. In most cases, symptoms only appear when other factors cause the levels of lipids in the blood to increase. The most noticeable signs are fat deposits on the palms, elbows, and arms. They can also show on the knees, buttocks, and knuckles. Both types 3 and 4 HLP increase the risk of coronary artery disease.
Symptoms of type 5 HLP vary from person to person. These may include a notable reduction of high-density lipoprotein (HDL) levels and reduced low-density lipoprotein (LDL) levels. Symptoms also include higher chylomicron levels and very low-density lipoprotein (VLDL) levels.
Who to See and Types of Treatment Available
Patients showing signs listed above are advised to consult a general doctor for an initial assessment. If the doctor suspects HLP, the patient will be referred to a lipid specialist. Lipid specialists can be cardiologists and doctors who specialise in the endocrine system.
Diagnosing the condition involves a thorough physical exam and reviewing the patient’s medical history. The medical history of their family is also reviewed. This is followed by blood tests to measure the levels of lipids in the blood. Fat deposits in certain areas of the body are also examined.
Other diagnostic tests are also used. These tests can include liver function tests. These can also include tests that aim to check uric acid levels in the blood as well as blood glucose levels. The doctor will also check protein levels in the urine and thyroid function.
Treatment of the condition largely depends on the type. However, doctors often prescribe medications that aim to lower the patient’s cholesterol blood levels. Patients are also advised to make healthy lifestyle changes. They must commit to eating a healthy diet and exercising on a regular basis. Achieving and maintaining a healthy weight can greatly improve treatment outcomes. Avoiding stress, smoking, and drinking too much alcohol also helps.
World Health Organization Memorandum;”Classification of Hyperlipidemias and Hyperlipoproteinemias”; http://circ.ahajournals.org/content/circulationaha/45/2/501.full.pdf
National Organization for Rare Disorders;”Hyperlipoproteinemia Type III”; https://rarediseases.org/rare-diseases/hyperlipoproteinemia-type-iii/