By Stephen J. Nicholls
Functional method of prognosis & administration of Lipid issues is an invaluable consultant designed to aid physicians in making a correct overview and constructing a entire therapy plan for sufferers with lipid problems. This concise and informative handbook covers key issues corresponding to rules of lipids and their function in atherosclerosis, scientific method of evaluate, healing techniques, administration of particular sufferer populations, and the position of imaging modalities.
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Additional resources for Practical Approach to Diagnosis & Management of Lipid Disorders
Nephrotic syndrome is classically associated with elevated levels of LDL cholesterol, triglycerides, and Lp(a), as a result of increased hepatic apoB synthesis, due to reduced oncotic pressure and reduced catabolism of LDL and lipoprotein lipase activity. Treatment of the underlying cause of nephrotic syndrome is accompanied by improvement of lipid levels. Use of standard lipid-lowering therapies can be effective, although patients must be carefully monitored for adverse effects. indd 28 9/30/09 2:12:02 PM Evaluation of Secondary Causes of Dyslipidemia 29 Table 5-2: Secondary Causes of Hypertriglyceridemia ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Diabetes mellitus Chronic renal failure Obesity Nephrotic syndrome Cushing syndrome Lipodystrophy HIV Cigarette smoking Excess alcohol consumption High-carbohydrate diets ■ Thyroid Disease ■ ■ ■ Hypothyroidism is associated with elevated levels of LDL cholesterol and triglyceride, either in isolation or combination, with the degree of abnormality related to the extent of thyroid deficiency.
Interestingly, red yeast rice contains monacolins, which inhibit HMG CoA reductase and therefore lower LDL-C levels. Diets enriched with nuts and fiber are also associated with reductions in LDL-C, further supporting their inclusion in dietary guidelines for cardiovascular prevention. Furthermore, lowering LDL-C is one of the mechanisms that underlie the potential protective influence of extracts from green tea. ■ Suggested Reading Burnett JR, Huff MW. Cholesterol absorption inhibitors as a therapeutic option for hypercholesterolaemia.
Spontaneous plaque rupture within the coronary arteries has been reported in cholesterol-fed, inbred strains of Watanabe rabbits and with cholesterol feeding in mice with genetic deletions of both apoE and the scavenger receptor SR-BI. Interestingly, these animals experience extensive myocardial damage and a high incidence of sudden death. ■ Current Therapeutic Approaches Lifestyle Modification Counseling with regard to dietary modification and performance of regular exercise constitute the cornerstone of all approaches to lowering LDL cholesterol.