Hyperlipidemia & Dyslipidemia

Question 1

What is dyslipidemia?

Answer 1

Abnormal blood lipid and lipoprotein concentrations

Question 2

What is the most common form of dyslipidemia ?

Answer 2

Hyperlipidemia

Question 3

Describe hyperlipidemia

Answer 3

Elevated LDL, TRG and decreased HDL

Question 4

What are severe forms of dyslipidemia usually caused by?

Answer 4

Genetic defects in cholesterol metabolism

Question 5

What is the ‘‘two hit” phenomenon?

Answer 5

o First hit = Genetic predisposition

o Second hit = Exacerbation by secondary factors that worsen lipid levels

Question 6

What is the optimal value of LDL?

Answer 6

100 mg.dL

Question 7

What is are high values of LDL?

Answer 7

160-189 mg.dL

Question 8

What is inadequate esterification?

Answer 8

Inability of the adipose tissue to change free fatty acids into triglycerides leading to high levels of FFA’s going back to the liver

Question 9

What causes an increase in free fatty acids?

Answer 9

Inadequate esterification

Question 10

What is a optimal value of TC?

Answer 10

less than 200 mg.dL

Question 11

How does weight loss improve cholesterol levels?

Answer 11

Reduced VLDL
Increased insulin sensitivity
Decreased hepatic lipogenesis

Question 12

What proteins can start insulin resistance or diabetes in obese clients?

Answer 12

Adipocytokines

Question 13

What type of protein does adipose tissue prominently source?

Answer 13

Cholesteryl ester transfer protein

Question 14

What does cholesteryl ester transfer protein activity and mass cause?

Answer 14

Stimulates TRG synthesis in the liver, therefore leading to the assembly and secretion of TRG containing VLDL

Question 15

How is the liver affected when insulin resistance occurs?

Answer 15

The liver produces excessive VLDL

Question 16

What causes small dense LDL to form?

Answer 16

Lots of triglycerides- Hypertriglyceridaemia

Question 17

How do small, dense LDL increase CVD risk?

Answer 17

o Reduced LDL receptor mediated clearance
o Increased arterial wall retention
o Increased susceptibility to oxidation

Question 18

What is the goal of medical management in dyslipidemia?

Answer 18

Increase the sensitivity of insulin therefore improve lipoprotein abnormalities

Question 19

What are first line treatments of dyslipidemia?

Answer 19

Weight reduction, increased physical activity, and decreased alcohol intake

Question 20

At exercise training volumes of 1200 to 2200 kcal/week what effects does it have on cholesterol levels?

Answer 20

TG levels may be reduced by 4% - 37%
LDL-C levels reduced by 0 - 7%
HDL-C levels increased by 2% to 8%

Question 21

How do statins work in dyslipidemia?

Answer 21

1. Inhibit HMG-CoA reductase thus directly inhibit cholesterol biosynthesis
2. Upregulation of LDL receptor on hepatocytes thus promote clearance of LDL-C

Question 22

How do statins effect muscles?

Answer 22

Causes myalgia (muscle weakness or soreness)

Question 23

Special considerations of dyslipidemia during exercise testing:

Answer 23

Presence of other chronic diseases and health conditions (e.g. metabolic syndrome, obesity, hypertension)

Question 24

What are the exercise recommendations for dyslipidemia with no co-morbidities?

Answer 24

Same as the healthy population

Question 25

What are the exercise recommendations for dyslipidemia

Answer 25

• Frequency - >5 days/week to maximise caloric expenditure
• Intensity – 40-75% VO2R or HRR
• Time – 30-60min, however to maintain healthy weight loss – 50-60minutes/day or more of daily exercise is recommended
• Type – Aerobic exercises that involve large muscle groups

Question 26

What is HMG-CoA reducatase responsible for?

Answer 26

Rate control of cholesterol biosynthesis in lover

Question 27

What increases levels of Adipocytokines?

Answer 27

Adipose tissue - an endocrine organ