What is dyslipidemia?

Dyslipidemia, also known as lipid metabolism disorder, is a condition characterized by abnormalities in one or more blood lipid parameters, such as elevated cholesterol, increased triglycerides, high LDL-C (low-density lipoprotein cholesterol), and decreased HDL-C (high-density lipoprotein cholesterol). This condition often coexists with and serves as a risk factor for cardiovascular, endocrine, and metabolic diseases.

Causes of dyslipidemia

Primary dyslipidemia
This form is genetically inherited and caused by mutations in one or more genes. The most common cases involve elevated LDL-C and triglycerides. Familial hyperlipidemia can manifest as early as adolescence, especially in individuals with a family history of high blood lipid levels.

Secondary dyslipidemia
This condition results from unhealthy lifestyle choices and underlying medical conditions, such as:

• Excessive calorie intake, obesity
• Type 2 diabetes
• Hypothyroidism
• Chronic kidney disease, nephrotic syndrome
• Metabolic syndrome, cushing’s syndrome

This type of dyslipidemia accounts for 30–40% of all cases.

Who is at risk for dyslipidemia?

• Elderly individuals & Postmenopausal women, Overweight or obese individuals
• People with Type 2 diabetes
• Individuals with metabolic syndrome
• Those diagnosed with Cushing’s syndrome or hypothyroidism
• Patients with chronic liver or kidney disease
• Individuals with inflammatory bowel disease
• Smokers or people with a sedentary lifestyle
• Individuals consuming high amounts of saturated and trans fats
• Heavy alcohol consumers
• Those with a family history of dyslipidemia

Symptoms of dyslipidemia

Dyslipidemia can progress silently for years without any noticeable symptoms. In most cases, the condition is detected incidentally during routine health check-ups.

Regular health check-ups help in the early detection and effective treatment of dyslipidemia

Symptoms and complications of dyslipidemia

Some symptoms of dyslipidemia may become noticeable when prolonged high blood lipid levels lead to organ complications. Signs that may indicate dyslipidemia include:

• Corneal arcus around the iris
• Xanthelasma on the upper or lower eyelids
• Tendinous xanthomas appearing on the fingers, Achilles tendon, and metacarpophalangeal joints
• Subperiosteal xanthomas found on the anterior tibial tuberosity and olecranon process
• Cutaneous or tuberous xanthomas occurring on the elbows and knees
• Palmar xanthomas appearing in the creases of the fingers and palms

Recognizing dyslipidemia

• Retinal lipid deposition
• Fatty liver disease
• Acute pancreatitis
• Atherosclerosis

Complications of dyslipidemia

Atherosclerosis is one of the most dangerous complications of dyslipidemia. Elevated LDL-C levels in the blood accumulate within the arterial walls, forming atherosclerotic plaques along with other substances. These plaques thicken and harden the arteries, facilitating platelet adhesion and initiating blood clot formation and vascular blockage.

Consequences of atherosclerosis include:

• Coronary artery disease, leading to myocardial infarction (heart attack)
• Carotid artery atherosclerosis, increasing the risk of stroke
• Peripheral artery disease, causing ischemia and necrosis of the limbs

Dyslipidemia also increases the risk of obesity, hypertension, and diabetes, which are additional risk factors for cardiovascular diseases. Therefore, individuals diagnosed with dyslipidemia should undergo a comprehensive cardiovascular risk assessment to develop an effective treatment plan and implement lifestyle modifications.

Other complications of dyslipidemia include acute pancreatitis (often due to elevated triglycerides), fatty liver disease, retinal lipid deposits, and xanthomas on the skin, tendons, and subperiosteal regions.

Treatment and prevention of dyslipidemia

The management of dyslipidemia requires a combination of medication and lifestyle changes aimed at restoring lipid levels to a normal range. Lifestyle modifications include:

• Weight management for overweight or obese individuals
• Regular physical activity for at least 30 minutes per day, five days a week, tailored to individual health conditions
• Reducing sugar and saturated fat intake, particularly animal fats and skin
• Limiting cholesterol-rich foods such as egg yolks, butter, and shrimp
• Increasing fiber and vitamin intake from vegetables and fruits
• Incorporating healthy fats from plant-based oils and fatty fish
• Restricting alcohol consumption.

Early detection and proper management of dyslipidemia play a crucial role in preventing severe complications and improving overall health.

Regular exercise effectively helps prevent dyslipidemia.

If lifestyle modifications alone are not effective, lipid-lowering medications may be required for treatment. Common drug classes include statins, fibrates, nicotinic acid, resins, ezetimibe, and omega-3 fatty acids. The selection and combination of medications depend on various factors, including medical history, patient risk factors, age, overall health condition, and potential side effects.

A personalized treatment plan will be prescribed by a physician to ensure the most effective and appropriate management of dyslipidemia for each individual.

This article has been reviewed by Dr. Dinh Thi Xuan Mai, Specialist in Endocrinology and General Internal Medicine at Hoan My Gold PXL Medical Center.

For consultation or to schedule an appointment, please contact Hoan My Gold PXL hotline: 0901 840 678 or book an appointment at https://forms.office.com/r/5w2HZPZpP0