Multiple lipoprotein-type hyperlipidemia
Key points
- This is an inherited disorder of high serum cholesterol and/or high blood triglycerides People with this condition have an increased risk of cardiovascular disease.
- This disease is genetic and inherited, although the specific defective genes have not been identified.
- The goal of treatment is to reduce the risk of atherosclerotic heart disease.
- A complication is early atherosclerotic heart disease or myocardial tissue death due to lack of blood (infarction).
Alternative names
Familial combined hyperlipidemia
Definition
This is an inherited disorder of high serum cholesterol and/or high blood triglycerides People with this condition have an increased risk of cardiovascular disease.
Causes, incidence, and risk factors
This disease is genetic and inherited, although the specific defective genes have not been identified. The person's cholesterol or triglyceride levels become elevated during the teenage years and continue throughout life. The types of elevated lipoproteins may vary between affected family members.
Cholesterol deposits in the skin, called xanthomas, which are seen in other disorders of elevated lipoproteins are rarely seen in this disorder. This disorder predisposes the person to greater risk of early coronary artery disease and therefore, heart attacks. People with the condition have a higher rate of obesity and glucose intolerance.
The condition is worsened by diabetes, alcoholism, and hypothyroidism. Risk factors are a family history of high cholesterol and early coronary artery disease. This is the most common disorder of increased blood fats that causes early heart attacks. The rare person who gets 2 defective genes is at much higher risk for early heart attack due to very high blood fat (cholesterol or triglyceride) levels.
Symptoms
- The person may be obese
- Chest pain (angina)
- Family history of early heart attack or increased blood fats
Note: There may be no symptoms.
Signs and tests
- elevated serum LDL or VLDL
- elevated total cholesterol
- decreased or normal serum HDL cholesterol
- elevated triglycerides
- elevated apolipoprotein B100 test
- pedigree analysis may show parent or child with high blood fat
Treatment
The goal of treatment is to reduce the risk of atherosclerotic heart disease.
The first step is to change what you eat. This is tried for several months before drug therapy is added. Diet changes include reducing total fat intake to less than 30% of the total calories consumed. Saturated fat intake is reduced by decreasing the amounts of beef, chicken, pork, and lamb; substituting low-fat dairy products for full-fat ones; and eliminating coconut and palm oil. Cholesterol intake is reduced by eliminating egg yolks and organ meats.
Written and revised by
David Cohen, M.D.
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