Lipid disorders include conditions with elevated levels of cholesterol and/or triglycerides. The levels of low-density lipoprotein (LDL) cholesterol and triglycerides are considered when diagnosing a lipid disorder.
Low-density lipoprotein (LDL) cholesterol is also called the bad cholesterol. It is mostly made up of cholesterol and combines with other substances to form plaques in the arterial walls. This leads to atherosclerosis or the narrowing of the arteries which increases the risk of heart attack and stroke. Triglyceride is another form of fat in the body. It can be obtained from food or the conversion of excess calories to fat. Increased levels of triglycerides raise the risk of heart and vascular diseases.
An unhealthy diet and some medical conditions increase the levels of cholesterol and triglycerides. A diet high in saturated fat and/or trans fats increase the cholesterol levels of the body. Saturated fat is commonly found in cheese, milk, and butter while trans fats are present in peanut butter, margarine, and potato chips. Cholesterol levels also increase when there is lack of exercise and when a patient smokes. Triglyceride level increase in patients with high cholesterol levels, heart disease, and diabetes.
Lipid disorders do not present with characteristic signs and symptoms. Some symptoms only appear when significant damage has been done. A lipid profile is obtained through a blood test. This summarizes the total cholesterol and triglyceride levels of the patient. Fasting for at least 12 hours is required before the blood sample is obtained. It is advisable for adults at least 20 years old to measure their lipid profile every 4 to 6 years.
Normal, borderline and high levels of LDL, total cholesterol, and triglycerides.
130 – 159
200 – 239
150 – 199
Lipid disorders rarely present with signs and symptoms. Very high lipid levels can present the following symptoms:
Xanthomas – bumps on the skin and tendons due to fat deposits
Opaque white or gray rings around the edge of the cornea
Very high triglyceride levels can present with the following:
Enlargement of the liver or spleen
Tingling or burning feeling of the hands and feet
Pancreatitis presenting with severe abdominal pain
Commonly Prescribed Drugs
Lipid-lowering drugs are beneficial for patients with very high cholesterol levels or risk factors for heart attack or stroke. These drugs prevent the occurrence of coronary artery disease and reduce the risk of early death.
- HMG-CoA reductase inhibitors or statins block the enzyme responsible for the start of cholesterol synthesis. This ultimately blocks cholesterol formation. Total cholesterol, LDL cholesterol, very low-density lipoproteins (VLDL) cholesterol, and triglyceride levels decrease while high-density lipoprotein (HDL) levels increase. Thus, these drugs can be used in patients with high blood cholesterol and/or triglyceride levels. Examples of this class include atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin. Side effects: bloating, fatigue, loose stools, muscle aches due to inflammation or degeneration (rare)
- Bile acid binders are drugs that increase the excretion of bile acids from the intestines. This causes the liver to obtain LDL cholesterol from the bloodstream and utilize it for bile production. It ultimately decreases the levels of LDL cholesterol in the blood. Examples of this class include cholestyramine, colesevelam, and colestipol. Side effects: abdominal pain, bloating, constipation, reduced effectiveness of some drugs
- Ezetimibe inhibits the absorption of cholesterol in the small intestines. This decreases the levels of LDL cholesterol. Its advantage from other lipid-lowering drugs is its few serious side effects. Side effects: loose stools, face & lip swelling and muscle aches (rare)
- Fibric acid derivatives decrease high triglyceride levels while increasing HDL production. These drugs also inhibit the production of VLDL, the lipoprotein used to produce LDL cholesterol. This class of drugs include fenofibrate and gemfibrozil. Side effects: bloating, gallstones, high liver enzyme levels
- Niacin is beneficial for patients with low HDL levels. It can increase the levels of HDL in the body as well as decrease triglycerides. Niacin is less commonly prescribed and usually considered only when a patient cannot tolerate statins. Side effects: stomach upset, flushing, itchiness, gout