Download MBBS Hyperlipidemia Lecture PPT

Hyperlipidemia.

? abnormally elevated levels of any or all lipids

--- Content provided by FirstRanker.com ---

and/or lipoproteins in the blood but Plasma

cholesterol and triglyceride are clinically

important because they are major modifiable

--- Content provided by FirstRanker.com ---

risk factors for cardiovascular disease, whilist

severe hypertriglyceridaemia also predisposes

--- Content provided by FirstRanker.com ---

to acute pancreatitis.
the story of lipids.

? Chylomicrons---
? Transport fats from the intestinal

--- Content provided by FirstRanker.com ---

mucosa to the liver.

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

--- Content provided by FirstRanker.com ---

and some cholesterol and become low density

lipoprotein. Then carries fat and cholesterol the body's

--- Content provided by FirstRanker.com ---

cells. Oxidized LDL cholesterol---Atheroma formation.

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

excretion.

--- Content provided by FirstRanker.com ---

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

Lipoprotein

--- Content provided by FirstRanker.com ---

Cholesterol

Fraction

--- Content provided by FirstRanker.com ---

level

elevated

TAG level

--- Content provided by FirstRanker.com ---

Type I

Chylomicrons

--- Content provided by FirstRanker.com ---

N

Type IIA

LDL

--- Content provided by FirstRanker.com ---

N

Type IIB

--- Content provided by FirstRanker.com ---

LDL and VLDL

Type III

Broad beta-

--- Content provided by FirstRanker.com ---

VLDL and

Chylomicrons

--- Content provided by FirstRanker.com ---

Type IV

VLDL

Type V

--- Content provided by FirstRanker.com ---

VLDL

N

--- Content provided by FirstRanker.com ---

Chylomicrons
Causes of Hyperlipidemia

v Diet
v Hypothyroidism

--- Content provided by FirstRanker.com ---

v Nephrotic syndrome
v Anorexia nervosa
v Obstructive liver disease
v Obesity
v Diabetes mellitus

--- Content provided by FirstRanker.com ---

v Pregnancy
? Diabetes Mellitus--Acetyl CoA pool is increased

and more molecules are channeled to

--- Content provided by FirstRanker.com ---

cholesterol'

? Obstructive jaundice---
? Excretion of cholesterol

--- Content provided by FirstRanker.com ---

through bile is blocked.

? Hypothyroidism--The receptor for HDL on liver

cells are decreased and so excretion is not

--- Content provided by FirstRanker.com ---

effective.

? Nephrotic syndrome--ALBUMIN is lost through urine,

--- Content provided by FirstRanker.com ---

( globulin and lipoprotein ) are increased as a

compensatory machanism.
? ATHERSCLEROSIS-The elevation of lipids in

--- Content provided by FirstRanker.com ---

plasma leads to the deposition of cholesterol

on arterial wall.

? IHD and CVA--Thromboembolic episodes in

--- Content provided by FirstRanker.com ---

coronary and cerebral vessels leads to

myocardial infarction and stroke.
Xanthelasma.

--- Content provided by FirstRanker.com ---

? XANTHOMA-The deposition of lipid in

subcutaneouas tissue.

? CORNEAL ARCUS- Deposits of lipids in

--- Content provided by FirstRanker.com ---

cornea, indicating hypercholestremia.

? Hyperlipidemia, in order to highest to lowest

--- Content provided by FirstRanker.com ---

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

HYPOLIPOPROTEINSMIAS

Familial hypobetalipoproteinemia:

--- Content provided by FirstRanker.com ---

It is an inherited disorder.

Due to an impairment in the synthesis of apo B.

--- Content provided by FirstRanker.com ---

The plasma LDL concentration in the affected

individuals is between 10 to 50 of normal

values.

--- Content provided by FirstRanker.com ---

This disorder is harmless & the individuals

have healthy and long life.
ABETALIPOPROTEINEMIA

--- Content provided by FirstRanker.com ---

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

synthesis of apoprotein B.

--- Content provided by FirstRanker.com ---

? It is characterized by a total absence of B-

lipoprotein (LDL) in plasma.

? Triacylglycerols are not found in plasma, but

--- Content provided by FirstRanker.com ---

they accumulate in liver & intestine.

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

--- Content provided by FirstRanker.com ---

retardation.
FAMILIAL ALPHA-LIPOPROTEIN DEFICIENCY

(TANGIER DISEASE)

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

hypercholestremia)

? There is elevation of LDL.

--- Content provided by FirstRanker.com ---

? Patients seldom survive the second decade of

life due to ischemic heart disease.

? The cause is LDL receptor defect.

--- Content provided by FirstRanker.com ---

TYPE IIA(PRIMARY FAMILIAL HYPERCHOLESTREMIA).

? Receptor deficiency in liver and peripheral

tissues will result in the elevation of LDL levels

--- Content provided by FirstRanker.com ---

in plasma, leading to hypercholesterolemia.

? The LDL receptor defect may be due to the

--- Content provided by FirstRanker.com ---

following reasons.
1. LDL receptor deficiency.

2. Defective binding of B-100 to the LDL

--- Content provided by FirstRanker.com ---

receptors.

? This defect is known as B-3500 or familial

defective apo B.

--- Content provided by FirstRanker.com ---

3. Receptor-LDL complex is not internalized.

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

--- Content provided by FirstRanker.com ---

nephrotic syndrome and cholestasis.
Goals of Lipids.

? LDL
? <100-------------optimal.

--- Content provided by FirstRanker.com ---

? 100--129------Near optimal.
? 130---159------Borderline.
? 160--189--------High.
? 190--------------Very high.
? total cholesterol

--- Content provided by FirstRanker.com ---

? <200----------Desirable.
? 200----239----Borderline.
? 240------------Very High.
? HDL
? <40------Low

--- Content provided by FirstRanker.com ---

? 60----High
? serum Triglycerides
? < 150--Normal
? 150--199--Borderline.
? 200--499----High

--- Content provided by FirstRanker.com ---

? 500? Very High.
Non-pharmacologic

Management of hyperlipidemia.

--- Content provided by FirstRanker.com ---

Your Text Here
PREVENTIONSION OF

ATHEROSCLEROSIS.

--- Content provided by FirstRanker.com ---

Reduce dietary cholesterol.

Vegetables oil and PUFA

Green leafy vegetables

--- Content provided by FirstRanker.com ---

Exercise

Hypolipidemic drug.
Pharmacologic

--- Content provided by FirstRanker.com ---

Treatment
Medication for Hyperlipidemia.

Drug class

--- Content provided by FirstRanker.com ---

Agent

HMG COA Reductase

--- Content provided by FirstRanker.com ---

LOVASTATIN.

inhibitor
Cholesterol absorption

--- Content provided by FirstRanker.com ---

Ezetimibe

inhibitor
Nicotinic acid

--- Content provided by FirstRanker.com ---

Fibric acid

Fenofibrate

Bile acid sequestrant

--- Content provided by FirstRanker.com ---

Cholesttyramine.
Risk factor cardiovascular Disease.

modifiable

--- Content provided by FirstRanker.com ---

Non-modifiable

Dyslipidemia--LOW HDL, High

--- Content provided by FirstRanker.com ---

age

LDL, Triglycerides
smoking

--- Content provided by FirstRanker.com ---

gender

Raised blood pressure.

Family history of CHD.

--- Content provided by FirstRanker.com ---

Diabetes mellitus
Diet