hormonal and metabolic disorders
Dyslipidemia
Treatment of Dyslipidemia
Lose weight Exercise Decrease saturated fats in the diet Often lipid-lowering drugs Usually, the best treatment for people is to lose weight if they are overweight, stop smoking if they smoke, decrease the total amount of saturated fat and cholesterol in their diet, increase physical activity, and then, if necessary, take a lipid-lowering drug. Regular physical activity can help lower triglyceride levels and increase the HDL cholesterol level. An example is walking briskly for at least 30 minutes daily. Treating children may be challenging. The American Academy of Pediatrics and the National Heart, Lung, and Blood Institute recommend treatment for some children with high lipid levels. Diet changes are recommended. Lipid-lowering drugs may be given to some children with very high lipid levels who do not respond to changes in diet, particularly children with familial hypercholesterolemia. A diet low in saturated fat and cholesterol can lower the LDL cholesterol level. However, people with high triglyceride levels also need to avoid consuming large amounts of sugar (whether in foods or beverages), refined flour (such as is used in most commercial baked goods), and starchy foods (such as potatoes and rice). The type of fat consumed is important (see). Fats may be saturated, polyunsaturated, or monounsaturated. Saturated fats increase cholesterol levels more than other forms of fat. Saturated fats should provide no more than 5 to 7% of total calories consumed each day. Polyunsaturated fats (which include omega-3 fats and omega-6 fats) may help decrease levels of triglycerides and LDL cholesterol in the blood. The fat content of most foods is included on the label of the container. Large amounts of saturated fats occur in meats, egg yolks, full-fat dairy products, some nuts (such as macadamia nuts), and coconut. Vegetable oils contain smaller amounts of saturated fat, but only some vegetable oils are truly low in saturated fats. Margarine, which is produced from polyunsaturated vegetable oils, is usually a healthier substitute for butter, which is high in saturated fat (about 60%). However, stick margarines (and some processed foods) contain trans fats, which may increase LDL (bad) cholesterol levels and lower HDL (good) cholesterol levels. Margarines made primarily from liquid oil (squeeze or tub margarines) contain less saturated fat than butter, contain no cholesterol, and contain fewer trans fats than stick margarines. Margarines (and other food products) that contain plant stanols or sterols can help lower total and LDL cholesterol levels. Eating oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries, and apple pulp can help lower cholesterol. Eating lots of vegetables, fruits, and whole grains, which are naturally low in fat and contain no cholesterol, is recommended. Also recommended are foods rich in soluble fiber, which binds fats in the intestine and helps lower the cholesterol level. Such foods include oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries, and apple pulp.Psyllium, usually taken to relieve constipation, can also lower the cholesterol level. Treatment with lipid-lowering drugs depends not only on the lipid levels but also on whether coronary artery disease, diabetes, or other major Risk Factors are present. For people who have coronary artery disease or diabetes, the risk of heart attack or stroke can be decreased by the use of the lipid-lowering drugs called statins. People who have very high cholesterol levels or who have other high risk factors for heart attack or stroke also may benefit from taking lipid-lowering drugs. There are different types of lipid-lowering drugs: Statins Cholesterol absorption inhibitors Bile acid binders PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors Fibric acid derivatives Supplements of omega-3 fats Niacin Bempedoic acid Each type lowers lipid levels by a different mechanism. Consequently, the different types of drugs have different side effects and may affect lipid levels differently. Following a diet low in saturated fat when drugs are used is recommended. Lipid-lowering drugs do more than lower lipid levels—they can also prevent coronary artery disease. In addition, statins have been shown to reduce the risk of early death. People with very high triglyceride levels and who are at risk of pancreatitis may need both diet changes and triglyceride-lowering drugs, usually a fibrate or prescription omega-3 fatty acids. Medical procedures that lower cholesterol levels are reserved for people with very high levels of LDL cholesterol that do not respond to diet and lipid-lowering drugs. Such people include those with familial hypercholesterolemia. LDL apheresis is the most commonly done procedure. LDL apheresis is a non-surgical procedure where blood is drawn from the person and the LDL component is separated from the rest of the blood in a special machine. The blood (minus the LDL component) is then returned to the person. Any conditions that cause or are risk factors for elevations in cholesterol levels also need to be treated. So people with Diabetes Mellitus (DM) should carefully control their blood glucose levels. Kidney disease, liver disease, and Doctors usually do blood tests 2 to 3 months after treatment has started to determine whether lipid levels are decreasing. Once lipid levels have decreased sufficiently, doctors do blood tests once or twice a year. Doctors no longer use specific targets for lipid levels. Instead, doctors try to lower the lipid levels by a certain percentage, typically about 30 to 50%. Because some lipid-lowering drugs can sometimes cause muscle and liver problems, doctors usually do blood tests when the person starts drug therapy. Then, if the person develops side effects, initial (baseline) measurements are available for comparison. 