Secondary Dyslipidemia

Secondary Dyslipidemia

• Secondary Cause

  • Elevated LDL
  • Elevated Triglycerides

• Diet

  • Saturated or trans fats, weight gain, anorexia
  • Weight gain, very low-fat diet, high intake of refined carbohydrates, excessive Alcohol intake

• Diseases

  • Biliary obstruction, nephrotic syndrome
  • Nephrotic syndrome, CKD, lipodystrophies

• Disorders and altered states of metabolism

  • Hypothyroidism, obesity, pregnancy
  • DM (poorly controlled), hypothyroidism, obesity; pregnancy

• Drugs

  • Diuretics, cyclosporine, glucocorticoids, Amiodarone
  • Oral estrogens, glucocorticoids, bile acid sequestrants, protease inhibitors, retinoic acid

Why is it important to know about Secondary DLP? To treat the cause .. Guid us in manegment Secondary Causes of Dyslipidemia,

Drug-Induced Dyslipidemia

1. Thiazide & loop diuretics: ↑ TG 50% & ↑ LDL 5%
2. Beta-blockers: ↑ TG (20-50%); ↓ HDL 10-15%
3. Estrogens: ↓ LDL 10-25%, ↑ HDL (10-20%), ↑ TG 10-20%
4. Tamoxifen: like estrogen on lipids
5. Progestins: ↑ 5-20% LDL-C, ↓ HDL 5-10%, ↑ 10-45% TG.
6. Contraceptive: ↑ LDL(5-20%); ↑ TG (10-45%),
7. Alcohol: ↑ TG up to 50%, ▲ HDL
8. Glucocorticoids: ↑ TG 15-20%, ↑ LDL 5-10%.
9. Isotretinoin: ↑ TG 50-60%, ↑ LDL 5-20%, ↓ HDL-C 10-15%
10. Cyclosporines: ↑ TC 15-20%, ↑ LDL