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Dyslipidemia

Dyslipidemia indicates the presence of increased cholesterol in the blood. In general the cholesterol in the body is categorized as good and bad forms, thus referring to its functionality. Good cholesterol also known as high density lipoproteins are required for the body to carry out regular metabolic activities. Estimation of triglyceride levels in the blood serves as a key factor in identifying the amount of disordered fats in the body or dyslipidemia. Dyslipidemia is one of the important causes for the onset of coronary artery disease.

Clinical evaluations of blood cholesterol levels

Clinical presentation of blood cholesterol levels aids estimation of the onset of conditions such as dyslipidemia which leads to cardio vascular disease. Blood cholesterol determination includes the estimation of high density lipoproteins, triglycerides and low density lipoproteins. Values in the case of dyslipidemia contain increased total cholesterol levels i.e. high LDL levels and decreased HDL levels. These levels are checked on fasting for at least 10 hours. Clinical interventions are recommended in the treatment of dyslipidemia to understand the possibility of cardio vascular disease in a patient and to differentiate the primary and secondary categories of this disease.


Diabetes and dyslipidemia

Type 2 diabetes is an underlying medical condition in which dyslipidemia is often noticed. It is measured by the lipid profile analysis. Insulin resistance is the predominant cause of low serum HDL. Insulin resistance promotes another condition called hypertriglyceridemia. This eventually leads to the increase of LDL or low density lipoproteins in the blood which can initiate the onset of atherosclerosis. Patients suffering diabetes with increased values of LDL and VLDL fall under the risk group for coronary artery disease. In addition to this, the metabolism of lipids is directly associated with the release of thyroid hormone. In patients with diabetes and hypothyroidism, the chance of cardiovascular disease is imminent.


Other factors

Dyslipidemia can occur because of various factors. Most of them are induced by altered lifestyle patterns affecting the metabolism of a person. Obesity is the predominant cause of cardiovascular disease which is directly associated with the presence of dyslipidemia in the person. Symptoms associated are lethargy, gasping and difficulty in participating in any kind of physical activity. Alcohol consumption is also a major cause for the onset of dyslipidemia as it is related to the damage caused to the liver which produces major enzymes for lipid metabolism and fat emulsification processes. Other caused include Cushing's syndrome, Polycystic ovarian disease and liver cirrhosis.

Treatment

Dyslipidemia is a condition which is treated with effective counseling about healthy lifestyle choices. Eating right and handling stressful factors can subsequently act on the regulation of metabolism. Patients are advised to exercise regularly to prevent the onset of atherosclerosis caused because of dyslipidemia.

Cardiometabolic Syndrome

Cardiometabolic syndrome occurs from metabolic dysfunctions like hypertension, impaired glucose tolerance, insulin resistance, dyslipidemia and central adiposity. It is a group of risk factors that increase the risk towards a serious illness. This syndrome is also known as insulin resistance syndrome.


The condition is a combination of metabolic disorders and/or risk factors that include a combination of diabetes mellitus, obesity, Hyperlipidemia and systemic hypertension. If any one of the risk factors is present in the body, then it is a major concern but when a combination of these risk factors are present in the body then they lead to severe health issues like cardio metabolic disease. The components of this syndrome either independently or interdependently are risk factors for high cardiovascular diseases.

Affected people are mostly overweight or obese. People suffering from this syndrome are more likely to suffer from coronary heart disease and heart attack. Central adiposity is a major contributor that increases cardiometabolic risks.


This syndrome is now recognized as a disease by WHO and is sometimes referred to as Metabolic Syndrome X. Most people with type 2 diabetes are likely to suffer from cardiometabolic disease. People above the age of 60 are also most likely to suffer from this syndrome.


Bringing the risk factors under control can be highly challenging. However exercise, diet, therapy and cardio-metabolic programs can help deal with the condition. Therapy includes assessing behavior and habits both in the cognitive and psychological level.

It is understood that 25% of the world population suffers from this syndrome. Rise in obesity in the world population and aging are identified as key contributors this syndrome.


Identifying Cardiometabolic disease

Though there is no visible symptom, a large waistline, elevated diabetic level, fatigue etc could be symptoms that may collectively indicate presence of the disorder. The condition cannot be diagnosed without a lab test or a health care provider because this syndrome is a cluster of conditions. To diagnose the condition, the health care provider may look for the presence of three or more of the following conditions:


  • Fasting glucose greater than 100mg/dL

  • Central or abdominal obesity (measure of waist circumference)

  • Men - greater than 40 inches, women - greater than 35 inches

  • Blood pressure greater than or equal to 130/85 mmHg

  • HDL Cholesterol

  • Men - less than 40mg/dL, Women - less than 50mg/dL

  • Triglycerides greater than or equal to 150mg/dL

Cause and Risk factors

Genetics and environment play a major role in the cause of this syndrome. Genetic factors influence each component of the syndrome. Progressive weight gain, sedentary lifestyle and low activity levels are equal contributors towards this condition. This condition is present in 5% of people with normal body weight, 22% of people who are overweight and 60% of people who are obese. Smoking, high carbohydrate diet, sedentary lifestyle and post-menopause also cause this syndrome.


Cardio metabolic disease risks


  • People with fat accumulation in the liver, fatty liver which leads to inflammation and most probably to cirrhosis.

  • Kidneys may also get affected as there is protein leak into the urine.

  • Sleep apnea

  • Polycystic ovary syndrome

  • Increased risk of dementia with the aged

Treating this syndrome requires addressing several risk factors together. The focus lies on reducing the person's risk of diabetes and heart disease. Lifestyle modification is the best possible way to handle this syndrome. Weight reduction, reducing smoking, reducing alcohol, getting more active physically, etc helps in handling the condition.



Metabolically Healthy Obese

Metabolically Healthy Obese or MHO refers to those who classify as overweight or obese by BMI but do not suffer any metabolic abnormalities. In spite of being significantly overweight, they exhibit normal cholesterol levels, healthy blood pressure levels and no signs of diabetes.


MHO persons are obese but with favorable metabolic profile. They are a subgroup of obese persons but whose fat accumulation has not led to adverse metabolic effects such as insulin resistance, hypertension, dyslipidemia and impaired glucose tolerance. They do not exhibit the typical metabolic red flags that nearly always accompany obesity. Studies show that most persons who are metabolically healthy obese might be in a transient state heading down the road to metabolic disturbances if they do not make lifestyle changes.


The healthy obese tend to carry their fat in the subcutaneous layer, where it is not so harmful. It was also noticed that they did not have fatty livers thereby maintaining normal metabolic health. Do not confuse the metabolically healthy obese with those suffering from lipodystrophy – lack of fat cells. They might appear lean and sans fat, but they are most likely to have fatty livers and ectopic fat.


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Bibliography / Reference

Collection of Pages - Last revised Date: November 11, 2019