Etiology
The causative factors of dyslipidemia or hyperlipidemia
- Environmental (dietary or lifestyle)
- Genetic or secondary to certain disease conditions or
- Drugs.
Contents
🫀Environmental factors
These include diets high in saturated fats, excessive calorie intake, alcohol intake, and sedentary lifestyles. A diet and lifestyle change can help normalize elevated blood lipid levels.
🫀Genetic defects
These lead to familial hyperlipidemia. In such cases, the lipid levels may be alarmingly high and the risk of CHD is very high. Myocardial infarction can occur within the first two decades of life. Dietary modifications along with drug therapy are beneficial.
🫀Hyperlipidemia: Secondary to other conditions
The disorders that upset lipid metabolism include poorly controlled Diabetes mellitus, Kidney Disease ( Nephrosis and end stage renal disease) liver disease Hypothyroidism, and the use of drugs like oral contraceptives, diuretic steroids could be the cause of lipid imbalances.
🫀Symptoms
The main symptom is the presence of Xanthoma. This is yellow swelling, nodule, or plaque in the skin resulting from fat deposits. There are various types of Xanthoma for example in type 2B the Xanthoma may be on the hands, buttocks, knees upper eyelids. In type 3, the planar Xanthomas may be seen as creases of the palms of the hand and fingers. In Type 5 Xanthoma may be present on the back of the neck or buttock.
🫀Complications
- Pancreatitis
- Progressive atherosclerosis or a symptomatic coronary disease.
Excess of triglycerides hypertriglyceridemia and cholesterol hypercholesterolemia are usual problems for an increase in very low-density lipoprotein cholesterol VLDLc low-density lipoprotein cholesterol LDLc levels. The following are possible causes of elevated triglycerides and cholesterol and reduced HDLc levels.
🫀Possible causes of elevated triglycerides
- Obesity
- Uncontrolled diabetes
- Genetic
- Drugs
- Alcohol
- Hypothyroidism
- Liver disease
🫀Possible causes of elevated cholesterol
- Excess fat in the diet (saturated and cholesterol)
- Overweight or obesity
🫀Possible causes of reduced serum HDL levels
- Cigarette smoking
- Hyper-glyceridaemia
- Obesity
- Genetic factors
- Lack of exercise
- Uncontrolled Diabetes
- Drugs
- Progestational agents
- Steroids
- Hypothyroidism
- Liver disease
Maintenance of blood lipids within the normal range is the most essential objective to prevent the onset or progress of atherosclerosis, According to the National Cholesterol Educational Program NCEP, It is pertinent to lay stress on dietary and Lifestyle modifications to control the manifestation associated with elevated lipids whether or not the patient is on drug therapy.
Let us now proceed over the dietary management of hyperlipidemia and understand the role of nutrients in increasing blood lipids except HDLC and triglyceride levels we will begin with identification objectives of for the nutritional care process.
Goals of dietary treatment
The goals of dietary management alone or in conjunction with exercise or with lipid-lowering drugs are to reduce the total fat, saturated fat, and cholesterol intake. This is an attempt to reduce total cholesterol. LDL and triglyceride levels, also reducing the risk of atherosclerosis and modifying its progression in subjects with the disease.
There are several environmental factors apart from genetic attributes that increase the probability of developing dyslipidemia. For example, obesity is a high risk factor and one of the important causes of this is diet. We know that when we take more food than what we require it is accumulated as fat in our body. This raises the lipid level in the blood, which deposits in the arteries, and the excess calories are converted to fat in the body which results in excess weight a very important cause of obesity. This when compounded by a wrong lifestyle physically inactive, smoking, alcohol intake stress, etc. worsens the already harmful effects of imbalanced food. The fats in the food give twice as many calories (9Kcal/g of fat) as protein and carbohydrate; so very rich foods containing excess fat are the first culprits and the other nutrients as well could be involved.