From the Guidelines
Dyslipidemia is often asymptomatic until complications arise, and its primary signs include elevated levels of total cholesterol, LDL cholesterol, triglycerides, or decreased HDL cholesterol detected through blood tests, as well as physical manifestations such as xanthomas, xanthelasmas, and corneal arcus 1. The diagnosis of dyslipidemia is typically made through a combination of physical examination, medical history, and laboratory tests, including lipid profiles. Some individuals may present with symptoms such as chest pain, shortness of breath, or peripheral artery disease, which can indicate the presence of atherosclerotic cardiovascular disease.
- The primary signs of dyslipidemia include:
- Elevated levels of total cholesterol, LDL cholesterol, triglycerides, or decreased HDL cholesterol detected through blood tests
- Physical manifestations such as xanthomas (yellowish cholesterol deposits on tendons or skin), xanthelasmas (yellowish patches around the eyes), and corneal arcus (white or gray ring around the cornea)
- Severe hypertriglyceridemia can cause eruptive xanthomas (small yellow-red bumps) on the skin, lipemia retinalis (milky appearance of retinal blood vessels), and acute pancreatitis
- Regular lipid panel screening is recommended for adults, especially those with risk factors like family history of heart disease, obesity, diabetes, or hypertension, as early detection allows for lifestyle modifications or medication before complications develop 1.
- The management of dyslipidemia involves a combination of lifestyle modifications, such as dietary changes and increased physical activity, and medication, such as statins, to lower LDL cholesterol levels and reduce the risk of cardiovascular disease 1.
- Optimal goals for lipid levels include LDL cholesterol < 100 mg/dL, HDL cholesterol > 35 mg/dL, and triglycerides < 150 mg/dL, and initial therapy should consist of optimizing glucose control and medical nutritional therapy to limit the amount of calories from fat to 25–30%, saturated fat to < 7%, cholesterol < 200 mg/day, avoid trans fats, and aim for < 10% calories from monounsaturated fats for elevated LDL 1.
From the Research
Signs of Dyslipidemia
The signs of dyslipidemia, also known as abnormal levels of lipids in the blood, can be identified through various laboratory tests and assessments. Some of the key signs include:
- Elevated levels of low-density lipoprotein (LDL) cholesterol 2
- Decreased levels of high-density lipoprotein (HDL) cholesterol 2
- High levels of triglycerides, which can increase the risk of pancreatitis if greater than 1,000 mg/dL 2
- Presence of small, dense LDL particles and an accumulation of cholesterol-rich remnant particles, often seen in patients with type 2 diabetes and metabolic syndrome 3
- Hypertriglyceridemia, low HDL-cholesterol levels, and a preponderance of small, dense LDL particles, collectively known as the "lipid quartet" 3
Laboratory Tests for Dyslipidemia
Laboratory tests play a crucial role in the diagnosis and management of dyslipidemia. Some of the common tests used include:
- Measurement of serum cholesterol, triglycerides, and HDL-cholesterol 2
- Calculation of LDL cholesterol using the Friedewald equation 2
- Ultracentrifugation to determine VLDL or LDL cholesterol in certain cases 2
- Lipoprotein electrophoresis to detect chylomicrons and diagnose Type III dyslipidemia 2
- Apolipoprotein B-100 level measurement in young subjects with coronary artery disease and normal LDL cholesterol 2
- Measurement of lipoprotein lipase activity or apolipoprotein C-II levels in children and young adults with severe hypertriglyceridemia 2
Importance of Early Diagnosis
Early diagnosis of dyslipidemia is essential to prevent the development of cardiovascular disease and other related conditions. Modern methods of diagnosis, including laboratory tests and risk assessments, can help identify individuals with dyslipidemia and guide treatment strategies 4, 5, 6.