Dyslipidemias: Clinical Features and Evaluation

Question 1

How are LDL-C levels determined?

Answer 1

LDL-C = Total Cholesterol - HDLC - (Triglycerides/5)
This is an indirect measurement. When measured in a fasted state, total cholesterol is easy to determine, as is HDL cholesterol. VLDL is difficult to determine, but is known to be equal to 1/5 of the Tg level, thus VLDL = Triglycerides/5 (so long as Tg is less than 400mg/dl)

Question 2

How is the risk for atherosclerotic events assessed?

Answer 2

There are seven general categories:
Age (Male > Female)
Caucasian vs. African American
Higher total cholesterol
Lower HDL-C
Current Smoking
BP >140 or on antihypertensive medications
Diabetes

Question 3

What does “Secondary Cause of Hypercholesterolemia” mean and what are some examples of it?

Answer 3

Hypercholesterolemia can be caused by genetic factors, dietary factors, or by conditions that cause abnormalities in lipid metabolism. Secondary causes of hyperlipidemia cause abnormalities in lipid metabolism. These include:
Diets high in saturated and trans fats
Hypothyroidism
Nephrotic syndrome
Obstructive liver disease
Cyclosporine

Question 4

Name the five dyslipidemias

Answer 4

Increased LDL-C
Hypertriglyceridemia
Increased non-HDL-C
Low HDL-C
Increased lipoprotein-a