Dyslipidemia

In a lipid metabolism disorder (also dyslipidemia ) are cholesterol and / or triglyceride levels increased. More rarely, phospholipids, cholesterol esters, or free fatty acids can cause the error:

Formation

By food the body takes on many different fats. These fats and also body's fats are transported in the blood. The water-insoluble fats bind for the transport of proteins. This gives rise to so-called lipoproteins, which are spread over the whole blood.

There are too many lipoproteins in the blood, they penetrate into the vessel walls and call an inflammatory reaction produced by oxidation. To combat this, migrate specialized phagocytes, the macrophages so-called, into the vessel wall to reduce the excess of lipoproteins. The bloated macrophages, which normally escape to the successful " exterminating " the oxidized lipids from the vascular wall, are no longer able to do so, as has been formed over them during the feeding process, an endothelial cell layer. Due to the resulting narrowing of the blood vessel (since the macrophages possess a certain volume ) produced a high heart attack and stroke risk. If, namely, to a bursting of the cell layer located below the plaque ( the " bloated " macrophages), there is a large blood clot that blocks one second to the other the way for the blood forms. It comes to vascular occlusion (myocardial infarction or stroke, depending on the position of the plaque).

The disorder itself is mostly innate. Approximately every second German has a cholesterol level over 200 mg / dl (milligrams per deciliter ). One in ten of them suffers from a congenital lipid metabolism disorder.

Forms of disturbance

It shares the lipid metabolism disorder in two main groups: the primary and secondary dyslipidaemia.

Primary lipid disorders

The primary forms of the disorder is based on a hereditary metabolic defect. These include the primary forms of hyperlipidemia and hypertriglyceridemia. However, not only heredity plays a role. Other factors such as type of diet or obesity influence the development of the disorder.

Secondary dyslipidemia

The secondary forms of the disorder arise not because of a genetic defect, but due to various diseases:

• Diabetes mellitus type 2
• Hypothyroidism
• Nephrotic syndrome
• Liver disease

Furthermore, it can facilitate the use of certain medications, the emergence of the disorder:

• Diuretics
• Oral contraceptives
• Corticosteroids

In contrast to the primary metabolic disorders secondary lipid disorders can usually by healing the original disease underlying the disorder is based are cured.

Treatment

To combat a lipid metabolism disorder, you have to lower the cholesterol level in the blood. This is done primarily through a change in lifestyle with a change in diet and increased physical activity. Performs a change in lifestyle not a sufficient decrease in cholesterol levels in the blood, drugs must be used. Rich and the medication is not sufficient, what can be the case with severe familial dyslipidemia, plasmapheresis is sometimes necessary. The drugs used against dyslipidemia usually contain one or more of the following active ingredients:

• Statins as cholesterol synthesis enzyme inhibitor ( short CSE inhibitors)
• Ezetimibe
• Fibrates
• Nicotinic acid
• Anion exchange resins
• β -sitosterol
• Lomitapid

The choice of active ingredient depends on the nature of the increased fat value from the blood. Today, however, users will be using CSE inhibitor or fibrate. We distinguish three groups of high fat levels:

• Isolated hypercholesterolemia

In the isolated hypercholesterolemia only the cholesterol level is increased, the other blood fat levels are in the normal range. For treating almost all types can be used by lipid-lowering agents.

• Mixed hyperlipidemia

In the mixed hyperlipidemia both cholesterol as well as the Triglycerinwerte are increased. For therapy is used as a rule CSE inhibitors and / or fibrates.

• Isolated hypertriglyceridemia

In the isolated hypertriglyceridemia only the triglyceride value is increased, the other blood fat levels are in the normal range. For therapy, the treating physician primarily used nicotinic acid and / or fibrates.