Lipid Disorders: Causes, Symptoms, Diagnosis, and Treatment

Introduction:

The liver synthesizes the cholesterol required by the body. Cholesterol and other fats are carried in the bloodstream as spherical particles called lipoproteins. Lipoproteins contain low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fats called triglycerides. Lipid disorder refers to elevated levels of low-density lipoprotein (LDL) cholesterol, or triglycerides, that increase the risk of developing heart disease.

What Is Cholesterol?

Cholesterol is a constituent of lipoproteins. Cholesterol is found in the human body in two forms:

• Low-Density Lipoprotein (LDL): It is commonly termed ‘bad cholesterol, is produced by the body, and is also absorbed by the human body from cholesterol-rich foods such as red meat including beef, veal, lamb, and pork, baked and processed foods, and dairy products. LDL can combine with other fats in the blood, creating blockages in the arteries and thus, increasing the risk of cardiovascular diseases.

• High-Density Lipoprotein (HDL): It is commonly termed ‘good cholesterol', and has a protective effect on the heart. The main function of HDL is to transport harmful cholesterol out of the arteries, thus draining out cholesterol and promoting good health. It is good to have high levels of HDL in the blood. Consuming foods like flax seeds, chia seeds, nuts, green leafy vegetables, tofu, soy products, and fish like salmon and sardines raise the HDL level in the blood and positively affect the cholesterol level.

Ideally, it is essential to have high HDL “good” cholesterol and low LDL “bad” cholesterol for good health.

What Are Triglycerides?

A triglyceride is a type of fat mostly obtained from our food. However, our body also produces it when it converts excess calories to fat for storage. Some triglycerides are essential for certain cell functions, but excess triglycerides have a negative impact on health. Triglycerides in lower levels are good for health.

What Causes Lipid Disorders?

Lipid disorders are caused by high levels of low-density lipoprotein or bad cholesterol and high triglycerides. High bad cholesterol and high triglycerides are caused by foods high in certain types of fat, certain medical conditions, and other factors.

1. Foods high in saturated and trans fats:

Saturated Fats: Saturated fats are proven to increase LDL levels. Saturated fats are mostly found in animal-based food products such as milk, cheeses, butter, and steak. Plant-based foods include coconut, coconut oil, palm oil, and palm kernel oil.

Trans Fats: Trans fats are potentially more dangerous than saturated fats. Most commonly, trans fats are found in:

• Fried foods (such as french fries, deep-fried fritters, mozzarella sticks, and fish sticks).

• Margarine (used in baked foods such as cakes, biscuits, and cookies).

• Processed foods.

• Non-dairy coffee creamer.

• Meat and dairy.

2. Certain Medical Conditions: High blood cholesterol levels can be caused by:

• Diabetes.

• Hypertension (high blood pressure).

• Obesity or overweight.

• Hypothyroidism.

• Kidney disease.

• Metabolic syndrome.

• Polycystic ovarian syndrome (PCOS).

• Cushing’s syndrome.

• Inflamed pancreas (pancreatitis).

3. Lifestyle Factors: Certain lifestyle conditions resulting in an increased level of

cholesterol are:

• Lack of Physical Activity: Lack of exercise increases LDL levels resulting in lipid disorders.

• Smoking: Smoking results in a high level of LDL cholesterol that causes plaque in the arteries. Thus, smoking is injurious to health.

• Genetics: Lipid disorders can be hereditary.

• Medications: Certain medications such as diuretics, beta-blockers, Prednisone, Amiodarone, Cyclosporine, anabolic steroids, and human immunodeficiency virus (HIV) protease inhibitors.

What Are the Symptoms of Lipid Disorders?

High cholesterol and high triglyceride levels do not manifest as symptoms but can be sourced from laboratory testing. But, symptoms of lipid disorders may be seen in the form of heart diseases such as chest pain, nausea, and fatigue.

How Is a Lipid Disorder Diagnosed?

Lipid disorder can be diagnosed through laboratory testing like blood work. A lipid panel is a blood test that is ordered by healthcare providers very commonly to screen, monitor, and manage lipid disorders. The lipid panel includes four measurements of cholesterol levels and the measurement of triglycerides.

What Is a Lipid Profile Test?

A lipid panel measures five different types of lipids from a blood sample, including:

• Total cholesterol: It is the combination of LDL, VLDL, and HDL.

• Low-density lipoprotein (LDL) cholesterol.

• Very low-density lipoprotein (VLDL) cholesterol.

• High-density lipoprotein (HDL) cholesterol.

• Triglycerides.

A lipid profile must be done in a fasting state; an overnight fast for eight to ten hours is ideal for accurate results.

The other names of the lipid profile are:

• Lipid test.

• Cholesterol panel.

• Coronary risk panel.

• Fasting lipid panel or non-fasting lipid panel.

The optimal level for the standard cholesterol monitoring tests in a lipid panel are as follows:

• Total Cholesterol: The normal range is below 200 mg/dL.

• High-density Lipoprotein (HDL) Cholesterol: The optimal reference range is above 60 mg/dL.

• Low-density Lipoprotein (LDL) Cholesterol: The normal reference range is below 100 mg/dL (For people who have diabetes, the normal reference range is below 70 mg/dL).

• Triglycerides: The normal range is below 150 mg/dL.

What Are the Treatment Options for Lipid Disorders?

The treatment options include medications and lifestyle intervention.

Medications:

• Statins: Statins prevent the clogging of arteries by blocking a substance that is responsible for producing cholesterol. The liver then eliminates cholesterol from the blood. Commonly used statins are Atorvastatin, Fluvastatin, Rosuvastatin, Simvastatin, and Pravastatin.

• Cholesterol Absorption Inhibitors: These medications work by potentially lowering cholesterol levels by limiting the body’s absorption of dietary cholesterol.

• Bile Acid Sequestrants: These medications function by trapping bile resins that contain cholesterol. They prevent these bile resins from being reabsorbed in the small intestine.

• Fibrates: The mechanism of action of fibrates helps lower triglyceride levels in the blood.

• Omega Fatty Acid Supplements: These are available over the counter and are commonly used to lower triglycerides and LDL levels.

• Lifestyle Changes: Following a healthy diet and continued physical activity helps lower cholesterol and worsen lipid disorders.

How Can Lipid Disorders Be Prevented?

The measures to maintain healthy cholesterol and triglycerides include:

• Eating low-fat or low-fat dairy products.

• Avoid processed foods and refined carbohydrates that are high in trans fats.

• Consuming unsaturated fats instead of saturated fats and trans fats is a healthy choice.

• Avoiding red meat.

• Having lean meat in moderate portions.

• Moderate intensity physical activity for at least 30 minutes daily, four to five days a week.

• Avoiding fried foods.

• Avoiding smoking and alcohol use.

• Aim to increase the amount of omega-3 fatty acids in your diet.

Conclusion:

Lipid disorder is a common medical condition rapidly increasing in urban cities due to improper lifestyles. Medication and lifestyle changes, including dietary modification and physical activity, can help lower cholesterol levels.