ABSTRACT
Hyperlipidemias ...................................................................................................................................................................... 715 Types of Hyperlipidemias ....................................................................................................................................................... 715
Chylomicronemia (Type I Hyperlipoproteinemia) ............................................................................................................. 715 Hypercholesterolemia (Type IIa and Type IIb Hyperlipoproteinemias) ............................................................................ 718 Type III Hyperlipoproteinemia (Dysbetalipoproteinemia, Broad-Beta or Floating-Beta Disease) ................................... 719 Type IV Hyperlipoproteinemia .......................................................................................................................................... 720 Type V Hyperlipoproteinemia ............................................................................................................................................ 720
Dyslipoproteinemia (Atherogenic Dyslipidemia) ................................................................................................................... 721 Evaluation of Patients with Hyperlipidemia ........................................................................................................................... 721 Dietary Management of Hyperlipidemias ............................................................................................................................... 721
Diets to Lower Serum Cholesterol and LDL Cholesterol ................................................................................................. 723 Diets to Lower Serum TAG ................................................................................................................................................ 724 Diet and Lp(a) .................................................................................................................................................................... 725
Drug Management of Hyperlipidemias ................................................................................................................................. 725 Drugs to Lower Cholesterol .............................................................................................................................................. 725 Drugs Affecting TAG and HDL Concentrations ............................................................................................................... 725
References ............................................................................................................................................................................... 726
The production and metabolism of serum lipids and lipoproteins can be in uenced by genetic variation, as well as by nutrients in the diet.1,2 A number of factors are involved in the regulation of lipid metabolism (Table 42.1), and their abnormal expression or activity can result in changes in lipid or lipoprotein levels that may predispose an individual to atherosclerosis. Diet may be an important component in the modulation of the lipid and lipoprotein phenotype, and while these effects depend in part on an individual’s genetic background, general trends for nutrient effects have been observed. These are outlined in Table 42.2.
