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血脂异常

Dyslipidemia

作者信息

Pappan Nikos, Awosika Ayoola O., Rehman Anis

机构信息

St. George’s University (SGU) School of Medicine

University of Illinois College of Medicine

Abstract

Lipids, such as cholesterol or triglycerides, are absorbed from the intestines and carried throughout the body via lipoproteins for energy, steroid production, or bile acid formation. Major contributors to these pathways are cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and high-density lipoprotein (HDL). An imbalance of any of these factors, either from organic or nonorganic causes, can lead to dyslipidemia. Dyslipidemia results in abnormal levels of lipids (fats) in the blood, which can increase the risk of cardiovascular diseases. Lipids include LDL cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. Dyslipidemia is classified into 2 types: primary and secondary. Primary dyslipidemia is inherited and caused by genetic mutations that affect lipid metabolism. Secondary dyslipidemia is acquired and caused by lifestyle factors or other medical conditions that alter lipid levels. The most common forms of dyslipidemia are: LDL cholesterol is considered “bad” cholesterol because it can form plaques in the arteries and reduce blood flow. HDL cholesterol is considered “good” cholesterol because it can help remove LDL from the blood and protect against atherosclerosis. Triglycerides are stored in fat cells and released as energy when needed. High triglycerides can also contribute to plaque formation and inflammation in the arteries. Total cholesterol is the sum of LDL, HDL, and half of the triglyceride level. High total cholesterol can indicate an increased risk of heart disease and stroke. Dyslipidemia usually does not cause any symptoms, but it can be detected by a blood test measuring different lipids levels. The optimal lipid level varies depending on the individual’s age, sex, and other risk factors, but generally, the following ranges are recommended: LDL cholesterol: less than 100 mg/dL. HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women. Triglycerides: less than 150 mg/dL. Total cholesterol: less than 200 mg/dL. The treatment of dyslipidemia depends on the type and severity of the condition and the presence of other risk factors, such as diabetes, hypertension, obesity, or smoking. The main goals of treatment are to lower LDL cholesterol, raise HDL cholesterol, and reduce triglycerides. Preventing dyslipidemia is essential to reduce the risk of cardiovascular complications and improve the quality of life. The prevention strategies include: Screening for dyslipidemia regularly, especially for people with a family history or other risk factors. The frequency and type of screening depend on the individual’s age, sex, and health status, but generally, a lipid profile test is recommended every 4 to 6 years for adults and every 2 years for children and adolescents. Adopting a healthy lifestyle by eating a balanced diet with plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats, such as omega-3 fatty acids from fish, nuts, and seeds. Avoid foods high in cholesterol, saturated fats, trans fats, added sugars, and salt. If possible, engage in physical activity for at least 150 minutes weekly. Maintaining a healthy weight and body mass index, quitting smoking, and limiting alcohol intake are all recommended. Comorbidities such as diabetes, hypertension, hypothyroidism, chronic kidney disease, or liver disease can affect lipid levels or increase the risk of cardiovascular disease; therefore, it is important to remain compliant with any medications.

摘要

脂质,如胆固醇或甘油三酯,从肠道被吸收,并通过脂蛋白输送到全身,用于提供能量、合成类固醇或形成胆汁酸。这些途径的主要贡献者是胆固醇、低密度脂蛋白(LDL)胆固醇、甘油三酯和高密度脂蛋白(HDL)。这些因素中的任何一个失衡,无论是由器质性还是非器质性原因引起的,都可能导致血脂异常。血脂异常会导致血液中脂质(脂肪)水平异常,从而增加心血管疾病的风险。脂质包括低密度脂蛋白胆固醇、高密度脂蛋白(HDL)胆固醇和甘油三酯。血脂异常分为两种类型:原发性和继发性。原发性血脂异常是遗传性的,由影响脂质代谢的基因突变引起。继发性血脂异常是后天获得的,由生活方式因素或其他改变血脂水平的医疗状况引起。最常见的血脂异常形式有:低密度脂蛋白胆固醇被认为是“坏”胆固醇,因为它会在动脉中形成斑块并减少血液流动。高密度脂蛋白胆固醇被认为是“好”胆固醇,因为它有助于从血液中清除低密度脂蛋白并预防动脉粥样硬化。甘油三酯储存在脂肪细胞中,并在需要时作为能量释放。高甘油三酯也会导致动脉中斑块形成和炎症。总胆固醇是低密度脂蛋白、高密度脂蛋白和甘油三酯水平一半的总和。高总胆固醇可能表明心脏病和中风的风险增加。血脂异常通常不会引起任何症状,但可以通过测量不同脂质水平的血液检测来检测。最佳脂质水平因个体的年龄、性别和其他风险因素而异,但一般建议以下范围:低密度脂蛋白胆固醇:低于100毫克/分升。高密度脂蛋白胆固醇:男性高于40毫克/分升,女性高于50毫克/分升。甘油三酯:低于150毫克/分升。总胆固醇:低于200毫克/分升。血脂异常的治疗取决于病情的类型和严重程度以及其他风险因素的存在,如糖尿病、高血压、肥胖或吸烟。治疗的主要目标是降低低密度脂蛋白胆固醇、提高高密度脂蛋白胆固醇和降低甘油三酯。预防血脂异常对于降低心血管并发症的风险和改善生活质量至关重要。预防策略包括:定期筛查血脂异常,特别是对于有家族病史或其他风险因素的人。筛查的频率和类型取决于个体的年龄、性别和健康状况,但一般建议成年人每4至6年进行一次血脂谱检测,儿童和青少年每2年进行一次。通过食用富含水果、蔬菜、全谷物、瘦肉蛋白和健康脂肪(如鱼类、坚果和种子中的ω-3脂肪酸)的均衡饮食来采取健康的生活方式。避免食用高胆固醇、饱和脂肪、反式脂肪、添加糖和盐的食物。如果可能,每周至少进行150分钟的体育活动。建议保持健康的体重和身体质量指数、戒烟和限制酒精摄入。糖尿病、高血压、甲状腺功能减退、慢性肾病或肝病等合并症会影响血脂水平或增加心血管疾病的风险;因此,遵医嘱服药很重要。

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