Download MBBS Hyperlipidemia Lecture PPT

Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Latest Hyperlipidemia Lecture PPT


Hyperlipidemia.

? abnormally elevated levels of any or all lipids

and/or lipoproteins in the blood but Plasma

cholesterol and triglyceride are clinically

important because they are major modifiable

risk factors for cardiovascular disease, whilist

severe hypertriglyceridaemia also predisposes

to acute pancreatitis.
the story of lipids.

? Chylomicrons---
? Transport fats from the intestinal

mucosa to the liver.

? LDL---
? In the liver chylomicrons release triglycerides

and some cholesterol and become low density

lipoprotein. Then carries fat and cholesterol the body's

cells. Oxidized LDL cholesterol---Atheroma formation.

? HDL---Carry fat and cholesterol back to the liver for

excretion.

? Atherogenic cholesterol---LDL, VLDL, IDL.
Type

Lipoprotein

Cholesterol

Fraction

level

elevated

TAG level

Type I

Chylomicrons

N

Type IIA

LDL

N

Type IIB

LDL and VLDL

Type III

Broad beta-

VLDL and

Chylomicrons

Type IV

VLDL

Type V

VLDL

N

Chylomicrons
Causes of Hyperlipidemia

v Diet
v Hypothyroidism
v Nephrotic syndrome
v Anorexia nervosa
v Obstructive liver disease
v Obesity
v Diabetes mellitus
v Pregnancy
? Diabetes Mellitus--Acetyl CoA pool is increased

and more molecules are channeled to

cholesterol'

? Obstructive jaundice---
? Excretion of cholesterol

through bile is blocked.

? Hypothyroidism--The receptor for HDL on liver

cells are decreased and so excretion is not

effective.

? Nephrotic syndrome--ALBUMIN is lost through urine,

( globulin and lipoprotein ) are increased as a

compensatory machanism.
? ATHERSCLEROSIS-The elevation of lipids in

plasma leads to the deposition of cholesterol

on arterial wall.

? IHD and CVA--Thromboembolic episodes in

coronary and cerebral vessels leads to

myocardial infarction and stroke.
Xanthelasma.
? XANTHOMA-The deposition of lipid in

subcutaneouas tissue.

? CORNEAL ARCUS- Deposits of lipids in

cornea, indicating hypercholestremia.

? Hyperlipidemia, in order to highest to lowest

incidence are Type IIA, Type IIB, IV, I, III and V.

HYPOLIPOPROTEINSMIAS

Familial hypobetalipoproteinemia:

It is an inherited disorder.

Due to an impairment in the synthesis of apo B.

The plasma LDL concentration in the affected

individuals is between 10 to 50 of normal

values.

This disorder is harmless & the individuals

have healthy and long life.
ABETALIPOPROTEINEMIA

? This is a rare disorder due to a defect in the

synthesis of apoprotein B.

? It is characterized by a total absence of B-

lipoprotein (LDL) in plasma.

? Triacylglycerols are not found in plasma, but

they accumulate in liver & intestine.

? Serum cholesterol level is low.
? Impairment in physical growth & mental

retardation.
FAMILIAL ALPHA-LIPOPROTEIN DEFICIENCY

(TANGIER DISEASE)

The plasma HDL particles are almost absent.
The plasma TG are elevated.
Increased risk of atherosclerosis.
type ii a.( pimary Familial

hypercholestremia)

? There is elevation of LDL.

? Patients seldom survive the second decade of

life due to ischemic heart disease.

? The cause is LDL receptor defect.
TYPE IIA(PRIMARY FAMILIAL HYPERCHOLESTREMIA).

? Receptor deficiency in liver and peripheral

tissues will result in the elevation of LDL levels

in plasma, leading to hypercholesterolemia.

? The LDL receptor defect may be due to the

following reasons.
1. LDL receptor deficiency.

2. Defective binding of B-100 to the LDL

receptors.

? This defect is known as B-3500 or familial

defective apo B.
3. Receptor-LDL complex is not internalized.

? Secondary type II hyperlipopteinemia is seen
in hypothyroidism, diabetes mellitus,

nephrotic syndrome and cholestasis.
Goals of Lipids.

? LDL
? <100-------------optimal.
? 100--129------Near optimal.
? 130---159------Borderline.
? 160--189--------High.
? 190--------------Very high.
? total cholesterol
? <200----------Desirable.
? 200----239----Borderline.
? 240------------Very High.
? HDL
? <40------Low
? 60----High
? serum Triglycerides
? < 150--Normal
? 150--199--Borderline.
? 200--499----High
? 500? Very High.
Non-pharmacologic

Management of hyperlipidemia.

Your Text Here
PREVENTIONSION OF

ATHEROSCLEROSIS.

Reduce dietary cholesterol.

Vegetables oil and PUFA

Green leafy vegetables

Exercise

Hypolipidemic drug.
Pharmacologic

Treatment
Medication for Hyperlipidemia.

Drug class

Agent

HMG COA Reductase

LOVASTATIN.

inhibitor
Cholesterol absorption

Ezetimibe

inhibitor
Nicotinic acid

Fibric acid

Fenofibrate

Bile acid sequestrant

Cholesttyramine.
Risk factor cardiovascular Disease.

modifiable

Non-modifiable

Dyslipidemia--LOW HDL, High

age

LDL, Triglycerides
smoking

gender

Raised blood pressure.

Family history of CHD.

Diabetes mellitus
Diet

This post was last modified on 30 November 2021