Dyslipidemia and metabolic syndrome

Česká verzia

Authors: V. Soška
Authors place of work: Centrum pro diagnostiku a léčbu dyslipidemií, Oddělení klinického komplementu FN u sv. Anny, Brno, přednosta doc. MUDr. Vladimír Soška, CSc.
Published in the journal: Vnitř Lék 2005; 51(1): 77-81
Category: Reviews

Summary

Dyslipidemia is common part of the metabolic syndrome. The typical lipid disorders are hypertrigylceridemia and low HDL-cholesterol. Elevation of small LDL3 and apolipoprotein B100 are also present in most patients. Weight reduction, diet and regular physical activity are the most effective way how to treat this type of dyslipoproteinemia. Before hypolipidemic drug therapy is started, type of dyslipidemia must be considered. Fibrates are recommended in patients with hypertriglyceridemia and low HDL-cholesterol. When high LDL-cholesterol is present, statin therapy is recommended. In some patients therapy with both fibrate and statin is needed to reach target lipid levels.

Key words:
dyslipidemia – metabolic syndrome – HDL-cholesterol – triglycerides – LDL3

Zdroje

1. Assmann G, Schulte H, von Eckardstein A. Hypertriglyceridemia and elevated lipoprotein(a) are risk factors for major coronary events in middle–aged men. Am J Cardiol 1996; 77: 1179–1184.

2. Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol1998; 81 (4A): 7B–12B.

3. Castelli WP. Epidemiology of triglycerides: a view from Framingham. Am J Cardiol 1992; 70: 3H–9H.

4. Cífková R et al. Prevence ischemické choroby srdeční v dospělém věku. Vnitř Lék 2000; 46 (Suppl. 14): 14–20.

5. Češka R. Cholesterol a ateroskleróza. Praha: Maxdorf 1999.

6. De Graaf J, Veerkamp MJ, Stalenhoef AF. Metabolic pathogenesis of familial combined hyperlipidaemia with emphasis on insulin resistance, adipose tissue metabolism and free fatty acids. J Royal Soc Med 2002; 95 (Suppl. 42): 46–53.

7. Eisenberg S. High-density lipoprotein metabolism. In: Betteridge DJ, Illingworth DR (Eds.): Lipoproteins in health and disease. London: Arnold 1999.

8. European guidelines on cardiovascular disease prevention in clinical practice. Third joint task force of European and other societies on cardiovascular disease prevention in clinical practice. Eur Heart J 2003; 24: 1601–1610.

9. Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults: Executive summary of the third report of the National cholesterol education program (NCEP) expert panel of detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III). JAMA 2001; 285 (19): 2486–2497.

10. Frick MH, Elo O, Haapa K et al. Helsinky Heart Study: Primary prevention trial with gemfibrozil in middle aged men with dyslipidemia. N Engl J Med 1987; 317: 1237–1245.

11. Gibbons GF, Brown AM, Wiggins D et al. The role of insulin and fatty acids in the regulation of hepatic verylow- density lipoprotein assambly. J Royal Soc Med 2002; 95 (Suppl 42): 23–32.

12. Griffin J et al. Role of plasma triglyceride in the regulation of plasma low density lipoprotein (LDL) subfractions: relative contribution of small, dense LDL to coronary heart disease risk. Atherosclerosis

1994; 106: 241–253.

13. Jančík J, Svačinová H, Dobšák P et al. Kombinovaný trénink u nemocných se systolickou dysfunkcí levé komory srdeční. Vnitř Lék 2003; 49(4): 280–284.

14. Manninen V, Tenkanen L, Koskinen P et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentration on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment. Circulation 1992; 85: 37–45.

15. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high–risk individuals: a randomised placebo–controlled trial. Lancet 2002; 360: 7–22.

16. Pocock SJ, Shaper AG, Philips AN. HDL-cholesterol triglycerides and total cholesterol in ischemic heart disease. Br Med J 1989; 298: 998–1002.

17. Prevention of Coronary Heart Disease in Clinical Practice. Summary of Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention, 1998.

18. Rubins HB, Robins SJ, Collins D et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. N Engl J Med 1999; 341: 410–418.

19. Sacks FM. For the Expert Group on HDL cholesterol: The role of high-density lipoprotein (HDL) cholesterol in the prevention and treatment of coronary heart disease: Expert group recommendations. Am J Cardiol 2000; 90: 139–142.

20. Saxena U, Witte LD, Goldberg IJ. Release of endothelial lipoprotein lipase by plasma lipoproteins and free fatty acid. J Biol Chem 1989; 264: 4349–4355.

21. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 pateints with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 334: 1383–1389.

22. Shepherd J, Cobbe SM, Ford I. et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Prevention Study Group. N Engl J Med 1995; 333: 1301–1307.

23. Soška V. Poruchy metabolizmu lipidů: Diagnostika a léčba. Praha: Grada 2001.

24. Van Harmelen V, Reynosdottir S, Cianflone K et al. Mechanisms involved in the regulation of free fatty acid release from isolated human fat cells by acylation stimulating protein and insulin. J Biol Chem 1999; 274: 18243–18251.

25. Weber, P, Kocourková B, Dočekalová A et al. Hyperlipidemie – možnosti léčby u diabetiků typu II. Geriatria 1999; 3–4: 115–122.

26. Zeman M, Žák A, Tvrzická E et al. Vliv fibrátů na složení lipoproteinů VLDL a LDL a parametry jejich oxidace u hypertriglyceridémie. Čas Lék Čes 2002; 7(141): 211–216.

27. Zilversmit DB. Atherosclerosis: a postprandial phenomen. Circulation 1979; 60: 473–485.