|
Subject: Re: hypolipoproteinemia
Forum: The Heart Forum
Topic Area:
Posted by CCF CARDIO MD - MTR on March 06, 1998 at 13:49:23:
In Reply to: hypolipoproteinemia posted by D. Switzer on March 05, 1998 at 02:07:38:
:
I have a family member who may have a genetic predisposition to very low
lipid levels (HDL and LDL). There is little written on the subject, and many of our local physicians are inexperienced with such matters. Can you shed any light on the possible dangers, concerns, causes (if not genetic), and treatments for low plasma lipid levels?
Thank you.
________Dear D. Switzer, thank you for your question. Low lipid levels are an area that is
certainly not as well studied as high lipid levels but I will try to shed some light
on the subject for you. LDL cholesterol is the most important of the lipid subfractions
and we have good, firm data that an LDL < 100 is the goal for anyone with known coronary
artery disease (atherosclerosis) or anyone with multiple risk factors for coronary disease
which include hypertension, diabetes, smoking, and a family history of premature coronary
disease (before age 55). If the LDL and HDL are low, there is little risk of problems since
the LDL is what drives prognosis the most. High HDL levels are protective against coronary
disease but that is not as important when the LDL is low. Women before menopause have
higher HDL levels which protect them against coronary disease. There are numerous genetic
predispositions to high LDL levels but I'm unaware of a genetic predisposition to low lipid
levels. There is a syndrome, however, where the HDL is low, the triglyceride is high,
hypertension is present, and diabetes is present. In this syndrome, high triglyceride
levels predispose patients to coronary disease. The causes of the syndromes are diverse
and are related to how the liver handles cholesterol at the cellular level. Overall, I
suggest that your family member have a complete lipid profile, a blood test for diabetes,
and serial blood pressure checks for hypertension. Once those tests are done, the prognosi
will be better defined. Information provided in the heart forum is for general purposes only. Specific diagnoses
and therapies can only be provided by your physician.
|
|
