Hyperchylomicronemia
Hyperchylomicronemia Causes
Abnormally high levels of lipid can accelerate atherosclerosis, or the process of hardening of the arteries. Normally, the arteries are unobstructed and smooth. But as people age, the arterial wall becomes lined with plaque, a sticky substance made up of lipids and other materials. As plaque accumulates, the arteries may narrow and eventually stiffen. An excess of plaque, i.e. lipids, thus reduce the flow of blood through the arteries. In Hyperchylomicronemia patients, this process is more likely to occur much earlier in life. An unhealthy lifestyle and a fatty diet are believed to be the main culprits of Hyperchylomicronemia. Obesity, lack of physical exercise, and smoking are some of the contributing factors. Conditions such as diabetes, kidney disease, pregnancy, and an under-active thyroid gland also often develop into Hyperchylomicronemia. Additionally, Hyperchylomicronemia may have genetic roots. In cases where patients have normal body weight, the cause was determined to have been hereditary.
Hyperchylomicronemia Definition
Hyperchylomicronemia, also known as hyperlipidemia or hyperlipoproteinemia, is characterized by elevated levels of lipids and/or lipoproteins in the blood. This lipid/lipoprotein abnormality, which is common in the general population, poses a high risk of developing into a cardiovascular disease because of the presence of high levels of cholesterol. Some forms of Hyperchylomicronemia may also lead to acute pancreatitis.
Hyperchylomicronemia Diagnosis
Hyperchylomicronemia, by itself, does not manifest symptoms. Therefore, blood tests to determine lipid levels are needed for diagnosis. According to the National Cholesterol Education Program, individuals aged 20 years old and above are strongly encouraged to periodically get tested every 5 years. The results of the blood test will then be compared to established ranges of lipid levels. Such ranges will aid the physician in diagnosing the disorder and then recommend treatment.
Hyperchylomicronemia Treatment
The mode of treatment will depend primarily on a patient's lipid level, risk for heart disease, and general wellbeing. Generally, the first step in Hyperchylomicronemia therapy is some drastic lifestyle changes that include diet modifications, an increase in physical activity, and of course, weight loss. In most cases, medication is recommended to lower lipid levels. This includes statin, bile acid sequestrants, fibrates, and niacin, among others. Classification and Treatment Hyperchylomicronemia Type I, known as the Buerger-Gruetz syndrome or familial hyperchylomicronemia, is marked by a decrease in lipoprotein lipase (LPL) or altered ApoC2. Type I is commonly diagnosed when elevated levels of Chylomicrons are found in lab tests. Diet control is the common treatment. Hyperchylomicronemia Type IIa, known as Polygenic hypercholesterolaemia or Familial hypercholesterolemia, is characterized by a deficiency in LDL receptors. Treatment for Type IIa is usually bile acid sequestrants, statins, and niacin. Hyperchylomicronemia Type IIb, or combined Hyperchylomicronemia, is characterized by a decrease in LDL receptors and an increase in ApoB. Elevated LDL and VLDL and Triglycerides are indicative of this form. Statins, Niacin, Gemfibrozil are used in treatment. Hyperchylomicronemia Type III, or Familial Dysbetalipoproteinemia, is marked by a defect in ApoE synthesis. An increase in IDL is a diagnostic sign of this form. Gemfibrozil is the drug of choice for Type II therapy. Hyperchylomicronemia Type IV, known as Endogenous Hyperlipemia, is characterized by an overproduction of VLDL and decreased excretion of the same. In Type III treatment, Niacin is often the drug of choice. Hyperchylomicronemia Type V, or Familial Hypertriglyceridemia, demonstrates an increase in production of VLDL and a decrease in LPL production. Niacin and Gemfibrozil are frequently used in treatment.