Lipid Disorders Flashcards
What is the single largest killer of men and women in the U.S.?
- CHD
What is the interrelation between atherosclerosis and insulin resistance?
- HTN
- obesity
- hyperinsulinemia
- DM
- hypertriglyceridemia
- high LDL
- low HDL
- hypercoagulability
What is metabolic syndrome according to the NCEP ATP III?
- if three or more of the following five criteria are met:
1. WAIST CIRCUMFERENCE over 40 inches (men) or 35 inches (women)
2. BP over 130/85 mmHg
3. fasting triglyceride (TG) level over 150 mg/dl
4. FASTING HDL cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women)
5. FASTING GLUCOSE over 110 mg/dl. - aka metabolic syndrome= a group of risk factors that raise your risk for heart disease, diabetes, and stroke.
What are some genetic lipoprotein disorders?
- familial combined hyperlipidemia
- familial hypercholesterolemia
- familial dysbetalipoproteinemia= accumulation of remnants of VLDL.
- hyperchylomicronemia
** What are our targets for lipids in T2DM?
- HDL= greater than 40 (men) or greater than 50 (women).
- LDL= less than 100
- TG= less than 150
What is non-HDL cholesterol and what is its significance?
total cholesterol - HDL
- consists of ApoB containing lipoproteins (aka VLDL, IDL and LDL) and other atherogenic lipoproteins.
What is the goal of Non-HDL cholesterol?
- LDL goal + 30
How do we treat lipid disorders?
- resins
- nicotinic acid
- fibrates
- STATINS (best for reducing the risk of cardiovascular events).
What are the new agents for treating lipid disorders?
- PCSK9 inhibitors= allow more LDL receptors to be recycled and present on the surface of cells to remove LDL-particles from the extracellular space (best and extremely effective when in combination with statins at lowering LDL cholesterol).
- cholesterol blockers
- mitochondrial transfer protein inhibitors
- CETP inhibitors
How does LDL specifically vary according to density?
- more dense LDL= more atherogenic.
* proportion of small, dense LDL particles is greater in pts with metabolic syndrome or DM vs. general population.
What happens to Apo B and Apo A-I in DM?
- Apo B= increased
- Apo A-I= decreased
What are the types of fish oil and do they help?
- EPA or DHA
* EPA helps more to lower TGs, but studies are ongoing.
What is Lpa?
- identical to LDL particle except for addition of apoA.
- plasma concentration is predictive of atherosclerotic disease.
- binds apoB containing lipoproteins and proteoglycans.
- thus important to lower.
Is homocysteine linked to atherogenesis?
- YES
How can we lower homocysteine levels?
- folate and vitamin B6 may reduce CVD risk.
