Hyperlipidemia & Dyslipidemia Flashcards
What is dyslipidemia?
Abnormal blood lipid and lipoprotein concentrations
What is the most common form of dyslipidemia ?
Hyperlipidemia
Describe hyperlipidemia
Elevated LDL, TRG and decreased HDL
What are severe forms of dyslipidemia usually caused by?
Genetic defects in cholesterol metabolism
What is the ‘‘two hit” phenomenon?
o First hit = Genetic predisposition
o Second hit = Exacerbation by secondary factors that worsen lipid levels
What is the optimal value of LDL?
100 mg.dL
What is are high values of LDL?
160-189 mg.dL
What is inadequate esterification?
Inability of the adipose tissue to change free fatty acids into triglycerides leading to high levels of FFA’s going back to the liver
What causes an increase in free fatty acids?
Inadequate esterification
What is a optimal value of TC?
less than 200 mg.dL
How does weight loss improve cholesterol levels?
Reduced VLDL
Increased insulin sensitivity
Decreased hepatic lipogenesis
What proteins can start insulin resistance or diabetes in obese clients?
Adipocytokines
What type of protein does adipose tissue prominently source?
Cholesteryl ester transfer protein
What does cholesteryl ester transfer protein activity and mass cause?
Stimulates TRG synthesis in the liver, therefore leading to the assembly and secretion of TRG containing VLDL
How is the liver affected when insulin resistance occurs?
The liver produces excessive VLDL
What causes small dense LDL to form?
Lots of triglycerides- Hypertriglyceridaemia
How do small, dense LDL increase CVD risk?
o Reduced LDL receptor mediated clearance
o Increased arterial wall retention
o Increased susceptibility to oxidation
What is the goal of medical management in dyslipidemia?
Increase the sensitivity of insulin therefore improve lipoprotein abnormalities
What are first line treatments of dyslipidemia?
Weight reduction, increased physical activity, and decreased alcohol intake
At exercise training volumes of 1200 to 2200 kcal/week what effects does it have on cholesterol levels?
TG levels may be reduced by 4% - 37%
LDL-C levels reduced by 0 - 7%
HDL-C levels increased by 2% to 8%
How do statins work in dyslipidemia?
- Inhibit HMG-CoA reductase thus directly inhibit cholesterol biosynthesis
- Upregulation of LDL receptor on hepatocytes thus promote clearance of LDL-C
How do statins effect muscles?
Causes myalgia (muscle weakness or soreness)
Special considerations of dyslipidemia during exercise testing:
Presence of other chronic diseases and health conditions (e.g. metabolic syndrome, obesity, hypertension)
What are the exercise recommendations for dyslipidemia with no co-morbidities?
Same as the healthy population
What are the exercise recommendations for dyslipidemia
- 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
What is HMG-CoA reducatase responsible for?
Rate control of cholesterol biosynthesis in lover
What increases levels of Adipocytokines?
Adipose tissue - an endocrine organ
