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J Exptl Med 2006;203:813-816. 3 Hyperlipidemia
Elevation of plasma lipids and lipoproteins
Cholesterol (Chol) Chol esters (CE) Triglycerides (TG)
Cholesterol (Chol), Chol esters (CE), Triglycerides (TG),
Lipid panel measures: total chol, HDL chol, & TG directly;
values for LDL chol are calculated
Friedwald equation: LDL Chol = Tot chol - (HDL + 0.2 * TG) Diet - Gene interactions
genetic variations affect plasma lipoprotein concentrations &
(apoB, LDL receptor, apoE, apoA, Lp(a), etc.) 4 Lipoprotein Metabolism Cascade
Metabolism Cascade 5 Lipoprotein Metabolism Cascade 6 Table 13-7, p. 301 7 Low Density Lipoprotein
Density Lipoprotein 8 9 10 National
National Cholesterol Education Program
(NCEP) Adult Treatment Panel (ATP) III
Classification of Cholesterol Levels Parameter Level (mg/dl) Classification LDL Cholesterol
Cholesterol <100 Optimal 130-159 Borderline High 160-189 High >190 Very High
High <200 Desirable 200-239 Borderline High
High >240 High <40 Low >60 High Total Cholesterol HDL Cholesterol
Cholesterol For conversion factors (mg/dl vs mmol/L) see JADA 2005 article
KNOW THESE 11 Table 13-8, p. 301 12 Table 13-10a, p. 305 13 NCEP ATP III Treatment Goals
Primary target is reduction of LDL cholesterol level
goal is adjusted based on risk factors present Secondary target is diagnosis & reduction of
underlying causes of the metabolic syndrome (diagnosis based on 3 of the following factors) abdominal obesity M >102 cm F>88 cm TG >150 mg/dl HDL chol M <40 mg/dl Insulin resistance Fasting BG >110 mg/dl HTN > 130/85 mm Hg F <50 mg/dl Treatment goals are achieved mainly with medical nutrition
management (diet and lifestyle/behavioral changes) and then
with drug therapy as needed. 14...
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This document was uploaded on 02/25/2013.
- Spring '10