Steinmetz A, Schäfer J R
Abteilung für Endokrinologie und Stoffwechsel, Zentrums Innere Medizin, Philipps-Universität, Marburg, Deutschland.
Wien Med Wochenschr. 1994;144(12-13):299-307.
Secondary hyperlipoproteinemias are found in connection with other primary organic diseases. Typical examples are those seen with diabetes mellitus, liver and kidney diseases. In addition there are changes induced by hormonal dysfunctions such as hypothyroidism, by the use of oral contraceptives or in postmenopausal women. During pregnancy there is a physiological transient increase in lipoproteins. In addition to primary organic diseases there are a number of exogenous factors such as obesity, malnutrition and alcohol abuse causing hyperlipidemia. The relation between hypertension and hyperlipidemia described as familial dyslipidemic hypertension is less well known. Obesity, hypertension, dyslipidemia, hyperuricemia and impaired glucose tolerance are the basic conditions of the metabolic syndrome. Familial combined hyperlipidemia is a genetically determined, dyslipidemic syndrome with a high prevalence among patients with coronary artery disease and stroke. As there are some links between familial combined hyperlipidemia and secondary hyperlipoproteinemias, this disease entity is discussed together in this paper. Familial combined hyperlipidemia is metabolically, genetically and by this on a molecular level closely linked to familial dyslipidemic hypertension as well as the metabolic syndrome. The exact mechanism of this disease is currently unknown.
继发性高脂血症与其他原发性器质性疾病相关。典型例子可见于糖尿病、肝脏和肾脏疾病。此外，还有由激素功能障碍（如甲状腺功能减退）、使用口服避孕药或绝经后女性所引起的变化。孕期脂蛋白会出现生理性短暂升高。除原发性器质性疾病外，还有许多外源性因素，如肥胖、营养不良和酗酒导致高脂血症。高血压与高脂血症之间的关系被称为家族性血脂异常性高血压，这一点鲜为人知。肥胖、高血压、血脂异常、高尿酸血症和糖耐量受损是代谢综合征的基本情况。家族性混合性高脂血症是一种由基因决定的血脂异常综合征，在冠心病和中风患者中患病率很高。由于家族性混合性高脂血症与继发性高脂血症之间存在一些联系，本文将对这一疾病实体一并进行讨论。家族性混合性高脂血症在代谢、遗传以及分子水平上与家族性血脂异常性高血压以及代谢综合征密切相关。目前该疾病的确切机制尚不清楚。
