Dyslipidemia

Why are high plasma levels of VLDL and LDL consider to be a risk factor for myocardial ischemia?

An increase in VLDL's and LDL's mean there are high levels of cholesterol (lipoproteins) in the blood that can accumulate and will build up as plaque in the arteries and causes endothelial injury, which will contribute to more lipid deposition in the atherosclerotic plaque. With time the artery will become occluced which will reduce blood flow to the tissue to cause risk for a myocardial ischemia.

what lipid serves as a component of cell membranes and is required for synthesis of steroid hormones, bile and vit. D.

Cholesterol

How does obesity or a BMI >30 increase risk for dyslipidemia?

Genetic factors may contribute to obesity and dyslipidemia. Visceral and abdominal adipose tissue produces signaling molecules that promote insulin resistance, thus increasing LDL and VLDL. Also you will have a decrease in HDL (good cholesterol) and levels of cardioprotective protein called adiponectin

what is the process of LDL production and metabolism?

HMG-CoA reductase pathway is the first step to cholesterol production. Insulin does induce this pathway. In the liver cells, cholesterol and other lipids bind to an apolipoprotein to form VLDL. VLDL is then excreted into the bloodstream by exocytosis and converted to IDL and eventually LDL.

Why are low plasma levels of HDL consider to be a risk factor for myocardial ischemia?

If you have low HDL levels then the bad cholesterol isn't being transported back to the liver to be metabolized and can build up in the tissues which causes plaque buildup and inflammation, increasing your risk for ischemia and MI

How does having a very sedentary life style contribute to dyslipidemia?

Lack of exercise is linked to obesity. There is evidence that inadequate physical activity will lower your good cholesterol (HDL), (helps remove the bad cholesterol from the tissues to the liver to be metabolized) which is an independent risk factor in the development of high cholesterol and atherosclerosis.

what dietary risk factors are there for high cholesterol?

There are certain foods that are high in cholesterol. Red meat and full fat dairy products should be eaten moderately to decrease your risk of high cholesterol and atherosclerosis. Eating foods high in saturated, hydrogenated and trans fats can increase your risk.

How is LDL taken up into the cells?

There has to be a LDL receptor to recognize the LDL to uptake it into the cytoplasm. There is a Genetic predisposition to not have receptors that make LDL accumulate in the bloodstream causing hypercholesterolemia.

why are HDL's a good lipoprotein?

They are cardio protective. remove lipids from tissues including lipids from a developing atherosclerotic plaque, inhibit inflammation and clotting and improve glycemic control.

How do statin lowering drugs work?

They block the HMG-CoA reductase pathway which reduces the production of cholesterol in the liver.

What are the 2 types of lipids?

Triglycerides and Cholesterol

Why is having several adult family members who take statins to control their 'cholesterol' levels a risk factor to you?

atherosclerosis does have a genetic risk factor. So, if you have family members that are affected, then it is important to check cholesterol levels at an earlier age to keep it in control.

what would you do for a patient with a genetic risk factor with dyslipidemia?

check lipoproteins levels at an earlier age

What is the relationship between Type II diabetes and dyslipidemia?

decrease of glucose uptake affects lipid metabolism. Insulin induces the production of cholesterol. Insulin resistance in adipose cells results in lipolysis. release of fatty acids into the bloodstream eventually leads to increases synthesis of VLDL by the liver, which leads to an increase in LDL's. We also see can increase in LDL oxidation which is a key process in atherosclerosis and an increase in triglyceride levels. HDL levels are usually lower in diabetic patients.

what is a IDL (intermediate-density lipoprotein) and function?

degraded cholesterol rich VLDL, used to form LDL. 50% of IDL's are transformed into LDL and the rest are taken up by the liver.

What labs do you look for to diagnose high cholesterol?

elevated LDL-C and or VLDL- serious risk factor for atherosclerosis. Low HDL-C- <40 (high risk) >60 (optimal) Elevated cholesterol <200- goal 200-239 -borderline high >240 high elevated triglycerides- <150 goal

What is a LDL (low-density lipoprotein) and function?

endogenous cholesterol that is transported in the plasma to the tissues. LDL's are either stored or used by the cell to make plasma membrane or steroid hormone. They are formed from VLDL's and IDL's- elevated LDL's are harmful.

what is the most prevalent cause of dyslipidemia?

familial combined hyperlipidemia and risk increases with age

what foods can decrease or can be protective against dyslipidemia?

fiber- 20-30 grams/day. in whole grains, legumes, fruits and veggies. garlic and soy products also thought to reduce cholesterol

Where is VLDL synthesized and secreted?

synthesized in the liver and secreted into the bloodstream

What is the function of VLDL (very low density lipoprotiens)

transport endogenous triglycerides and cholesterol to the tissues.

What is a HDL (high-density lipoprotein) and function?

transports Cholesterol and other lipids from the tissues to the liver to be metabolized and excreted in bile.

VLDL's are primarily made up of?

triglycerides

What lipid can the liver synthesize from glucose?

triglycerides

what lipid cleaves off of the LDL?

triglycerides and is either stored or used as a fuel source