Yanai Hidekatsu, Yoshida Hiroshi
Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan.
Department of Laboratory Medicine, The Jikei University Kashiwa Hospital, Chiba, Japan.
Glob Health Med. 2021 Feb 28;3(1):15-23. doi: 10.35772/ghm.2020.01078.
Dyslipidemia is classified into primary and secondary types. Primary dyslipidemia is basically inherited and caused by single or multiple gene mutations that result in either overproduction or defective clearance of triglycerides and cholesterol. Secondary dyslipidemia is caused by unhealthy lifestyle factors and acquired medical conditions, including underlying diseases and applied drugs. Secondary dyslipidemia accounts for approximately 30-40% of all dyslipidemia. Secondary dyslipidemia should be treated by finding and addressing its causative diseases or drugs. For example, treatment of secondary dyslipidemia, such as hyperlipidemia due to hypothyroidism, by using statin without controlling hypothyroidism, may lead to myopathy and serious adverse events such as rhabdomyolysis. Differential diagnosis of secondary dyslipidemia is very important for safe and effective treatment. Here, we describe an overview about diseases and drugs that interfere with lipid metabolism leading to secondary dyslipidemia. Further, we show the association of each secondary dyslipidemia with atherosclerosis and the treatments for such dyslipidemia.
血脂异常分为原发性和继发性两类。原发性血脂异常基本上是遗传性的,由单个或多个基因突变引起,这些突变导致甘油三酯和胆固醇的产生过多或清除缺陷。继发性血脂异常由不健康的生活方式因素和后天获得的疾病引起,包括基础疾病和使用的药物。继发性血脂异常约占所有血脂异常的30%-40%。继发性血脂异常应通过找出并治疗其致病疾病或药物来进行治疗。例如,在未控制甲状腺功能减退的情况下使用他汀类药物治疗继发性血脂异常,如甲状腺功能减退引起的高脂血症,可能会导致肌病和横纹肌溶解等严重不良事件。继发性血脂异常的鉴别诊断对于安全有效的治疗非常重要。在此,我们描述了干扰脂质代谢导致继发性血脂异常的疾病和药物概况。此外,我们展示了每种继发性血脂异常与动脉粥样硬化的关联以及此类血脂异常的治疗方法。