Michigan State University, East Lansing, MI, USA.
Am J Cardiol. 2012 Sep 15;110(6):823-5. doi: 10.1016/j.amjcard.2012.04.062. Epub 2012 Jun 2.
The causes of the lipid disorders in patients referred to specialty clinics for difficult-to-treat dyslipidemias are likely multifactorial. However, the importance of evaluating for secondary causes is unclear. The investigators performed a chart review of new patients referred to the University of Michigan Lipid Clinic from January 2004 to June 2011 (n = 824) to evaluate for the prevalence of several secondary causes of dyslipidemia. In addition to lipoproteins, new patients were assessed for secondary dyslipidemias by a standardized protocol consisting of laboratory testing, a nutritional evaluation, and medical history. These data were evaluated to determine the prevalence of several secondary causes of dyslipidemia. A total of 363 separate factors were identified in the 824 patients that were thought to be potential secondary causes of dyslipidemia. Because some patients (n = 83 [10%]) had multiple conditions, there were 230 (28% of the cohort) with ≥1 potential secondary dyslipidemias. The most common conditions were excessive alcohol intake (n = 82 [10%]), uncontrolled diabetes mellitus (n = 68 [8%]), and overt albuminuria. Although other causes occurred less frequently (each individually found in <5% of patients), altogether they were present in a substantial portion of patients (n = 102 [12%]). In conclusion, nearly 1/3 of patients referred to a specialty clinic had identifiable secondary conditions plausibly contributing to their dyslipidemia. Numerous disorders were identified, with diabetes mellitus and excessive alcohol being the most common.
导致患者脂质紊乱的原因可能是多因素的，这些患者被转介到专门的诊所治疗治疗困难的血脂异常。然而，评估继发性病因的重要性尚不清楚。研究人员对 2004 年 1 月至 2011 年 6 月期间被转介到密歇根大学脂类诊所的新患者（n=824）进行了图表回顾，以评估几种血脂异常的继发性病因的发生率。除了脂蛋白，新患者还通过标准化方案进行了继发性血脂异常的评估，该方案包括实验室检查、营养评估和病史。这些数据被评估以确定几种继发性血脂异常的发生率。在 824 名患者中，共发现了 363 个单独的因素，这些因素被认为是血脂异常的潜在继发性病因。由于一些患者（n=83[10%]）存在多种情况，因此有 230 名（队列的 28%）患者存在≥1 种潜在的继发性血脂异常。最常见的情况是过度饮酒（n=82[10%]）、未控制的糖尿病（n=68[8%]）和明显的白蛋白尿。尽管其他原因的发生率较低（每种情况在<5%的患者中发现），但它们在很大一部分患者中存在（n=102[12%]）。总之，近 1/3 被转介到专门诊所的患者存在可识别的继发性疾病，这些疾病可能是导致其血脂异常的原因。发现了许多疾病，其中糖尿病和过度饮酒最为常见。
