Lipids in heart disease Flashcards
Why are lipids needed in the body
- Importatn in constituent of the cell membranes
- helps in the absorption of fat soluble vitamins
- maintains membrane fluidity
- acts as a thermal insulator adn cellular metabolic regulator
- hormone synthesis - steroid synthesis
- organ padding
What are the fat soluble vitamins
A
B
E
K
What enzyme do statins inhibit
- HMG CoA reductase
What do statins lower
- Cholestrol level
What is cholestrol important for
- Vitamin D syntehsis
- steroids
- bile salts
What are modifiable cardiovascualr risk factors
- smoking
- high cholestrol
- hypertension
- high blood glucose
- obesity
What are the unmodifiable risk factros for cardiovascular disease
- Age
- gender
- family history
- ethinicty
The smaller the molecule
the smaller the moelcule the easier it is to penetrate between the endoithelial cells and go into the endothelium
- therefore easy for LDl molecules to get in adn less easy for VLDL adn IDL
Describe how LDLs, HDLs and chylomicrons work together
- Chylomicrons transport fat from the itnestinal mucsoa to the liver
- in the liver some of the chylomicrons release triglycerides and some cholestrol and become low density lipoproteins (LDL)
- LDL then carries fat and cholestrol to the bodys cells
- High density lipoproteins (HDL) Ccarr fat and cholestrol back to the liver for excretion
What is the difference between HDL and LDL
- LDL then carries fat and cholestrol to the bodys cells
- High density lipoproteins (HDL) Ccarr fat and cholestrol back to the liver for excretion
What are the two types of hyperlipidaemias
Primary
Secondary (more common)
What are causes of secondary hyperlipidaemia
∗ Diet ∗ Alcohol ∗ Hypothyroidism ∗ Nephrotic syndrome ∗ Anorexia nervosa ∗ Obstructive liver disease ∗ Obesity ∗ Diabetes mellitus ∗ Pregnancy ∗ Acute hepatitis ∗ Systemic lupus erythematousus ∗ Drugi nduced-Thiazides, B-blockers, anti retroviral drugs, anti-depressants
What do you look for in a fasting lipid profile
∗ Serum total cholesterol ∗ Serum LDL-cholesterol ∗ Serum (fasting) triglyceride ∗ Serum HDL cholesterol ∗ Cholesterol-HDL ratio
What is the friedewald formula
The Friedewald formula (FF) is an estimation of LDL-c level that uses the following levels of
- total cholesterol (TC),
- triglycerides (TG)
- high-density lipoprotein cholesterol (HDL-c):
LDL-c (mg/dL) = TC (mg/dL) − HDL-c (mg/dL) − TG (mg/dL)/5 [6, 11–13].
What levels do you use in the Friedewald formula (FF)
- total cholesterol (TC),
- triglycerides (TG)
- high-density lipoprotein cholesterol (HDL-c):
LDL-c (mg/dL) = TC (mg/dL) − HDL-c (mg/dL) − TG (mg/dL)/5 [6, 11–13].
What does the serum look like if you have high triglyceride
serum looks white
What can happen with high triglyercide
acute pancretitis
What causes primary hyperlipidaemia
genetic
Name a type of primary hyperlipidaemia
- Familial Hypercholesterolemia (FH)
- familial combined hyperlipideaemia
- dysbetalipoproteinemia
What happens in Familial Hypercholesterolemia (FH)
- Codominant genetic disorder, occurs in
heterozygous form - Mutation in LDL receptor, resulting in elevated levels of LDL at birth and throughout life
What are pateints with Familial Hypercholesterolemia (FH) at risk of
- Atheroscloeris
- tendon xanthomas (75% of patients)
- tuberous xanthomas
- xathelasmas of eyes
what is the genetics of familial combined hyperlipidaemia
- Autosomal dominant
What is there increased secretion of in familial combined hyperlipidaemia
- Increased secretions of VLDLs
What happens in dysbetalipoproteinemia
Results in apo E2, a binding-defective form of apoE (which usually plays important role in catabolism of chylomicron and VLDL)
