Hyperlipidaemia causes
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These studies suggest that hyperlipidaemia can be caused by genetic factors, secondary conditions such as endocrine and systemic diseases, and lifestyle factors like diet and drug use.
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Causes of Hyperlipidaemia
Hyperlipidaemia, characterized by elevated levels of lipids in the blood, is a significant risk factor for cardiovascular diseases. Understanding its causes is crucial for effective prevention and management. The causes of hyperlipidaemia can be broadly categorized into primary (genetic) and secondary (acquired) factors.
Primary Causes of Hyperlipidaemia
Genetic Factors and Familial Hyperlipidaemia
Primary hyperlipidaemia is often genetically determined, with over 60% of the variability in serum lipids attributed to genetic factors. Familial hyperlipidaemia, such as familial hypercholesterolaemia and familial combined hyperlipidaemia, are well-defined genetic disorders. These conditions are characterized by elevated levels of cholesterol and/or triglycerides, independent of environmental influences. In some cases, genetic predispositions require additional environmental or genetic factors to manifest, as seen in familial type III hyperlipoproteinaemia.
Secondary Causes of Hyperlipidaemia
Diet and Lifestyle
Dietary habits play a significant role in secondary hyperlipidaemia. Diets rich in saturated fats and cholesterol are common causes of mild hypercholesterolaemia. Excessive alcohol consumption and weight gain are major contributors to hypertriglyceridaemia. Additionally, anorexia nervosa has been associated with severe but reversible hypercholesterolaemia.
Medications
Several classes of drugs can alter lipid profiles. Glucocorticoids and estrogens elevate triglycerides and HDL-c levels, while anabolic steroids reduce HDL-c levels. Oral contraceptives can affect atherosclerotic risk depending on the type and dose of progestin/estrogen. Antihypertensive drugs have variable effects on lipids; for instance, beta blockers raise triglycerides and lower HDL-c, whereas alpha blockers may increase HDL-c. Other drugs, such as retinoids and cyclosporine, can also impact lipid levels.
Endocrine and Metabolic Disorders
Endocrine diseases, including hypothyroidism, diabetes mellitus, and hyperadrenocorticism, are significant secondary causes of hyperlipidaemia . Hypothyroidism is particularly common and should be considered in all new cases of clinically important hyperlipidaemia. Diabetes and other metabolic disorders can lead to altered lipid metabolism, contributing to elevated lipid levels .
Systemic Diseases
Systemic diseases such as renal and hepatic disorders can also cause secondary hyperlipidaemia. These conditions interfere with lipid metabolism, leading to elevated levels of cholesterol and triglycerides . Nephrotic syndrome and chronic renal failure are notable examples where lipid abnormalities persist despite treatment of the primary disorder.
Other Factors
Pregnancy and certain physiological states can also contribute to secondary hyperlipidaemia. For instance, pregnancy can exacerbate underlying primary hypertriglyceridaemia, leading to severe complications like pancreatitis.
Conclusion
Hyperlipidaemia is a multifactorial condition with both genetic and acquired causes. Primary hyperlipidaemia is largely genetic, while secondary hyperlipidaemia results from various lifestyle, medication, endocrine, and systemic factors. Recognizing and addressing these causes is essential for effective management and prevention of associated cardiovascular risks.
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