LIPID DISORDERS

Atherosclerosis
(ath"er-o-skleh-RO'sis)
--comes from the Greek words

athero (meaning gruel or paste)

sclerosis (hardness).

• The buildup of fats, cholesterol and other

substances in and on your artery walls.

• This buildup is called plaque.

• The plaque can cause your arteries to

narrow, blocking blood flow.

• The plaque can also burst, leading to a

blood clot.
Atherosclerosis
• --arteries are blood vessels
that carry oxygen and blood
to the heart, brain, and other
parts of the body.
•
--as plaque builds up in an
artery, the artery gradually
narrows and can become
clogged.
-as an artery becomes more
and more narrowed, less
blood can flow through.
•
--the artery may also become
less elastic ("hardening of the
arteries").
Risk factors raise your
chances of having
atherosclerosis:
having high blood cholesterol,
especially
Cholest
high LDL ("bad cholesterol") and
erol
low HDL("good cholesterol")
levels

aging and being male (women

Aging are affected more
after menopause)

having close relatives who had

Heart heart disease or a stroke at a
relatively young age

BP having high blood pressure

having diabetes

smoking

having trouble managing stress

having high levels of homocysteine (an

amino acid) in the blood

being obese

being physically inactive.

 Signs and symptoms
Atherosclerosis produces no
symptoms until the damage to the
arteries is severe enough to
restrict blood flow.
Restriction of blood flow to the
muscles of the legs causes
intermittent claudication (pains in
the legs brought about by walking
and relieved by rest).
Restriction of blood flow to the
heart muscle due to
atherosclerosis can cause angina
pectoris or a myocardial infarction
(a heart attack).
Narrowing of the arteries
supplying blood to the brain may
cause transient ischemic attacks
(symptoms and signs of
a strokelasting less than 24 hours)
and episodes of dizziness, or
ultimately, to a stroke itself.
 OBESITY
• medical condition in which
excess body fat has
accumulated to the extent
that it may have an adverse
effect on health, leading to
reduced life
expectancy and/or
increased health problems.

Body mass index (BMI)

a measurement which
compares weight and height,
defines people as overweight
(pre-obese) when their BMI is
between 25 kg/m2 and
30 kg/m2, and obese when it is
greater than 30 kg/m2
BMI Chart
 Increased weight

Increased BMI
SIGNS AND
SYMPTOMS Increased abdominal girth

Secondary medical
complications
 Risk Factors
Living in an
Having family
industrialized country, Not being physically
members who are
especially the United active
overweight or obese
States

Taking certain
prescription
Overeating Eating a high-fat diet
medications (see
"Causes" section)

Having a hormone Being emotionally

disorder, such as stressed (from the
Cushing syndrome or death of a loved one,
hypothyroidism for example), which
(underactive thyroid) may cause overeating
 Hyperlipidemia

--is an elevation of lipids (fats) in

the bloodstream.
--These lipids include cholesterol,
cholesterol esters
(compounds), phospholipids
and triglycerides.
--They're transported in the blood
as part of large molecules
called lipoproteins.
 Signs and
Symptoms
• deposits of cholesterol (known as
xanthomas) may form under the skin
(especially around the eyes or along
the Achilles tendon) in individuals with
familial forms of the disorder or in
those with very high levels of
cholesterol in the blood.
• Individuals with hypertriglyceridemia
may develop numerous pimple-like
lesions across their body.
• Extremely high levels of triglycerides
may also result in pancreatitis, a
severe inflammation of the pancreas
that may be life-threatening.
 RISKS
However, the greatest,
modifiable risk factor is
diet; a poor diet is one
with a fat intake greater
Causes of hyperlipidemia
than 40 percent of total
can include heredity and
calories, saturated fat
taking certain
intake greater than 10
medications.
percent of total calories;
and cholesterol intake
greater than 300
milligrams per day.
 Dyslipidemia

--is elevation of plasma

cholesterol, triglycerides
(TGs), or both, or a low
high density lipoprotein
level that contributes to
the development of
atherosclerosis
-- an abnormal amount
of lipids (e.g. cholesterol
and/or fat) in the blood.
The prolonged elevation
of insulin levels can lead
to dyslipidemia
 SIGNS AND SYPMTOMS

can lead to symptomatic

vascular disease, which eyelid xanthelasmas (flat
includes coronary artery yellow or white growths on
disease (CAD) and the upper eyelid)
peripheral arterial disease.

formation of eruptive
arcus corneae (an
xanthomas (yellow, soft,
abnormal white or gray
and slightly raised bumps)
opaque ring at the outer
over the hands, knees,
edge of the cornea).
back, elbows, etc.
 RISKS

Consuming a diet
having a family
high in saturated
history of the Being overweight
fats and
disorder
cholesterol

Being physically Consuming large

inactive amounts of alcohol
 LIPID STORAGE
DISORDER

• a group of inherited metabolic

disorders in which harmful
amounts of lipids (fats)
accumulate in some of the body’s
cells and tissues.
• People with these disorders
either do not produce enough of
one of the enzymes needed to
metabolize lipids or they produce
enzymes that do not work
properly.
• excessive storage of fats can
cause permanent cellular and
tissue damage, particularly in the
brain, peripheral nervous system,
liver, spleen and bone marrow.
 Lipid storage diseases can be inherited two
ways:
• Autosomal recessive inheritance

• occurs when both parents carry and pass

on a copy of the faulty gene, but neither
parent show signs and symptoms of the
condition and is not affected by the
INHERITANCE disorder.
• Each child born to these parents has a 25
percent chance of inheriting both copies of
the defective gene, 50 percent chance of
being a carrier, 25 percent chance of not
inheriting either copy of the defective
gene.
• Children of either gender can be affected by
an autosomal recessive this pattern of
inheritance.
 X-linked recessive (or sex linked) inheritance

• occurs when the mother carries the affected gene on the

chromosome that determines the child’s gender and passes it to her
son.
• Sons of carriers have a 50 percent chance of inheriting the disorder.
• Daughters have a 50 percent chance of inheriting the X-linked
chromosome but usually are not severely affected by the disorder.
• Affected men do not pass the disorder to their sons but their
daughters will be carriers for the disorder.
 HYPERCHOLESTEROLEMIA

• (literally: high blood cholesterol) is the

presence of high levels of cholesterol in the
blood. It is not a disease but a metabolic
derangement that can be secondary to many
diseases and can contribute to many forms of
disease, most notably cardiovascular
disease. It is closely related to the terms
"hyperlipidemia" (elevated levels of lipids)
and "hyperlipoproteinemia" (elevated levels
of lipoproteins).

• If it is hereditary (familial
hypercholesterolemia), there is more often a
family history of premature, earlier onset
atherosclerosis, as well as familial
 SIGNS AND
SYMPTOMS
• specific physical findings: xanthoma
(deposition of cholesterol in patches on
the skin or in tendons) xanthelasma
palpabrum (yellowish patches around
the eyelids) and arcus senilis (white
discoloration of the peripheral cornea).

• Longstanding elevated
hypercholesterolemia leads to
accelerated atherosclerosis; this can
express itself in a number of
cardiovascular diseases: coronary artery
disease (angina pectoris, heart attacks),
stroke and short stroke-like episodes
and peripheral vascular disease
 CAUSES

Diabetes mellitus Kidney disease

and metabolic (nephrotic Hypothyroidism Cushing's syndrome
syndrome syndrome)

Anorexia nervosa Sleep deprivation Zieve's syndrome Family history

Antiretroviral drugs, like

protease inhibitors and
nucleoside reverse Diet Body weight Physical activity
transcriptase inhibitors.
 Causes/Diseases Related to
HYPERCHOLESTEROLEMIA
Disease Meaning
Diabetis a disease in which the body’s ability to produce or respond to the
mellitus hormone insulin is impaired, resulting in abnormal metabolism of
carbohydrates and elevated levels of glucose in the blood and urine.
Nephronic kidney disorder that causes your body to pass too much protein in
syndrome your urine.
Hypo condition where the thyroid doesn't create and release enough thyroid
thyroidism hormone into your bloodstream.
Cushing a disorder that occurs when your body makes too much of the
syndrome hormone cortisol over a long period of time. Cortisol is sometimes
called the “stress hormone” because it helps your body respond to
stress
Anorexia People with anorexia nervosa eat an extremely low calorie diet and
nervosa have an excessive fear of gaining weight.
Zieve’s acute metabolic condition that can occur during withdrawal from
syndrome prolonged heavy alcohol use
 DIAGNOSIS

• There is no specific level at which

cholesterol levels are abnormal.
Cholesterol levels are found in a
continuum within a population.
Higher cholesterol levels lead to
increased risk of several diseases,
most notably cardiovascular
diseases. Specifically, high levels of
small LDL cholesterol particles are
associated with increased risk of
heart disease. Larger LDL particles
do not carry the same risk.
 In strictly controlled surroundings, such as a
hospital ward dedicated to metabolism
problems, a diet can reduce cholesterol
levels by 15%. In practice, dietary advice can
provide a modest decrease in cholesterol
levels and may be sufficient in the treatment
of mildly elevated cholesterol.

TREATMENT
While statins are effective in decreasing
mortality in those who have had previous
cardiovascular disease there is not a
mortality benefit in those at high-risk but
without prior cardiovascular disease
 An association between certain metabolic
disorders and cardiovascular disease has
been known since the 1940s.

Also known as syndrome X or the

dysmetabolic syndrome was coined to
METABOLIC designate a cluster of metabolic risk factors
SYNDROME that come together in a single individual.

In more current times, the term metabolic

syndrome is found throughout medical
literature and in the lay press as well.
 Genetic factors influence each individual component of
the syndrome, and the syndrome itself.

A family history that includes type 2 diabetes,

hypertension, and early heart disease greatly increases
the chance that an individual will develop the metabolic
syndrome.
Environmental issues such as low activity level,
sedentary lifestyle, and progressive weight gain also
contribute significantly to the risk of developing the
CAUSES metabolic syndrome.

While obesity itself is likely the greatest risk factor, other

factors of concern include:

• women who are post-menopausal,

• smoking,
• eating an excessively high carbohydrate diet,
• Lack of activity (even without weight change), and
• consuming an alcohol-free diet.
 TREATMENT
• Mediterranean diet -- one that is rich in
"good" fats (olive oil) and contains a
reasonable amount of carbohydrates
and proteins (such as from fish and
chicken).
• The Mediterranean diet is palatable and
easily sustained
 TREATMENT
• Exercise
• A sustainable exercise program, for example 30
minutes five days a week is reasonable to start,
providing there is no medical contraindication.
• There is a beneficial effect of exercise on blood
pressure, cholesterol levels, and insulin
sensitivity, regardless of whether weight loss is
achieved or not. Thus, exercise in itself is a
helpful tool in treating metabolic syndrome.
TREATMENT
• Cosmetic surgery to remove fat
• Some people may ask: Why not just have
liposuction of the abdomen and remove the
large amount abdominal fat, which is a big
part of the problem? Data thus far shows no
benefit in liposuction on insulin sensitivity,
blood pressure, or cholesterol. As the saying
goes, "If it's too good to be true, it probably
is." Diet and exercise are still the preferred
primary treatment of metabolic syndrome.
Thank you

Be Healthy