Dyslipidemia: A Focus on Hyper and Hypocholesterolemia

DYSLIPIDEMIA:This is  a condition  describing the amount of lipid  in the blood precisely  cholesterol and fat.(WHO 2000)
this condition can be described in two ways which are the hyper and hypolipidemia respectively (WHO 2000).

A disorder describing abnormal amount of cholesterol in the blood is termed dyslipidemia.(creckas 1997)

Dyslipidemia is described in two ways:

(A)  hyperlipidemia

(B) hypolipidemia

Hyperlipidemia is the elevation of  lipid in the blood ,may be due to diet and lifestyle such as exercise.( JONSON  et.al 2013)

prolong elevation of insulin level can also leads to dyslipidemia and increase in the level of o-glcNAc(WHO 2000)

CLASSIFICATION

Physician and researchers classified dyslipidemia in two distinct ways.( pie 2014)

    

  (1)  classification according to phenotype

  (2)  classification according to its etiology.

(Fredrickson et.al)

Phenotipical classification, is the presentation of this lipid that include the specific type that is increased,the etiology is the genetics .

                          ( fredrickson classification).

Phenotipic causes may include the elevation of lipoprotein,chylomycrons,low density lipoprotein and very low density lipoprotein

Another causes may include present of lipid in the protein  called lipoprotein.

. It may also include hyper lipoprotenemia when it is high and hypoprotenemia when its low 

It can also leads to honemia caused by chylomicrons,or both combination of hyperlipidemia low density lipoprotein and tryglyceride.

DIAGNOSTIC  TERMS

HYPO AND HYPERLIPIDEMIA FROM THE LIPID ORIGIN

HYPER AND HYPO CHOLESTEROLEMIA FROM CHOLESTEROL ORIGIN.

HYPER AND HYPOLIPOPROTEINEMIA FROM LIPO PROTEIN ORIGIN

A BETALIPOPROTENEMIA FROM BETTA LIPOPROTEIN ORIGIN.

TANGIER DISEASE CAUSED BY HIGH DENSITY LIPOPROTEIN.

LIPID IN BLOOD.

The present of lipid in the blood ,is of imperative  as it’s a measure of a healthy status of individual .

large quantity and low quantity  is recommended for clinical diagnosis.

CHOLESTEROL LEVEL

According to the American hearth Association,a total cholesterol level below 160mg/dl or its equivalent of 4.1mm/l is classified as hypocholesterolemia.

but there was a disput on this  as more researcher and physician re lowerd the level.(AHA1994).

HYPER CHOLESTEROLEMIA

This is the present of high level  of cholesterol in the blood,it is another form of hyperlipidemia or elevated level of lipid in the blood. And hyperlipoprotenemia or elevated levels of lipoprotein.

NATURALITY

Cholesterol is a sterol by origin,it is one of the majour clasis of lipid that animal cell utilizes  to construct their membrane and thus manufactured by animal cell.(Nature et.al1991)

cholesterol is a precusure of vitamin D steroids homones,and bile acid.

TRANSPORT

Cholesterol is transported in the blood plasma within protein particles.(Lipoprotein.).

Lipoprotein  are thus classified by their density :

very low density lipoprotein,(VLDL), Low density lipoprotein(LDL) , the intermediate density lipoprotein,(IDL)  AND high density lipoprotein(HDL).

All the lipoprotein carries cholesterol ,but elevated level of lipoprotein other than high density lipoprotein otherwise known as  high density lipoprotein cholesterol and low density lipoprotein cholesterol are in association with increased risk of atheroschlerosi and coronary herath disease.

Implication.

High level of high density lipoprotein cholesterol are protective. And elevated level of non high density lipoprotein and low density lipoprotein in the blood may be consequent of diet,obesity ,genetic disorder such as low density lipoprotein.

RECEPTORS MUTATION

Receptor mutation in hypercholesterolemia.or any diseasedof thyroid gland underreactive and diabetics mellitus. Thus reducing the saturated dietary fat is recommended to reduced total blood cholesterol and LDL in adult.

LDL EPHERESIS

In people with very high  cholesterol for e.g, in hypercholesterolemia, diet is often insufficient, therefor the disire to reduce the low density lipoprotein and lipid lowering medication with reduced cholesterol absorption is required.another treatment means is LDL ephresis is also required.

SIGNS AND SYMPTOMS.

Hypercholesterolemia is asymptomatic. Long standing elevation of  serum cholesterol  can lead to atherosclerosis. Chronically elevated serum cholesterol leads to the formation of atheromatous plaques in the arteries that can lead to steanosis (Narrowing)  of the atheries  or complete occlusion (Blockage) of the involved atheries.

RUPTURE OF THE PLAGUE

Smaller plaque may rupture and cause a clots to form  and obstruct the flow of blood.

and sudden occlusion of coronary atery result in myocardial infaction otherwise known as hearth attack.also,an occlusion of the cerebral ateries supplying  blood to the brain can cause stroke in the individual involved.prior to development of stenosis blood is gradually supply to the tissue or organs  slowly diminishes until the  organs functions becomes impaired.

HYPO-CHOLESTEROLEMIA.

This is a phenomena describing the low level of cholesterol in the blood.just as cholesterol is important to the living system,abnormal level of cholesterol  in the blood could have presumed the kind of anomalies in association with the living system.among the level of causes of hypocholesterolemia are: statins, hyperthyroidism, adrenal insufficient liver diseases intestinal malabsorption of lipid derivative food, malnutrition, abetalipoproteinemia, can lower cholesterol level to 50mg/dl,and its a genetic disorder, hypobetalipoproteinemia, manganese deficiency,smith- lemli-optiz syndrome, marfan syndrome, leukemia.

DEMOGRAPHIC STUDIES

Demographic studies surgest that cholesterol level form an u-shapecurve,ploted when ploted against mortality,this surgest that low cholesterol could be in association with increased mortality,due to depression,cancer and haemorrhagic stroke etc.

MEDICATION

The medication to be used in the treatment  of hypercholesterolemia are:

Statins (HMG-COAreductase inhibitors) is used if diet is ineffective.

Fibrates

Nicotinic acid

Cholestyramide(used in pregnancy and when body is intolerable to statins).

LIFE THERAPY

LIFE TIME THERAPY.

The life changes attitude recommended for those with high cholesterol include,

smoking cessation

lalcoholic  limitation( if it must be taken)

increasing physical activities

maintaining healthy weight.

Restric intake of saturated fat

Avoiding trans FAT.

A change in the diet can  reduce cholesterol  by 15%(Maxwell et,al 2004).

SCREENING

According to u.s  routine task force,it recommended a routine screening for men  of 35 years above and women of 45years above. For lipid disorder and,and treatment of abnormal lipid for people at risk of  coronary hearth disease.

CONCLUSION AND RECOMMENDATION

High level of high density lipoprotein cholesterol are protective. And elevated level of non high density lipoprotein and low density lipoprotein in the blood may be consequent of diet, obesity ,genetic disorder.

It is recommended to check  your cholesterol and fats level if you are 35 years old male and 40 years old female.

DO REGULAR CHECK UP 

By visiting your doctor, and making the lab your friend.