Endocrine Abstracts

In clinical practice, dyslipidaemia defines the elevated plasma total cholesterol, LDL cholesterol or triglycerides or the decreased HDL cholesterol levels. In recent years however, new laboratory methods helped us understand that the functions of lipoproteins are more important than their amounts. Dyslipidaemia is one of the most important and correctable risk factors for the atherosclerotic cardiovascular diseases (CVD). The epidemiological data recurrently show a very significant linear relationship between the elevated cholesterol levels and the risk of CVD. Genetic background and age are the two major predictors of serum cholesterol levels. In the developed countries, with a considerable amount elderly people, more than half of the population have increased total cholesterol levels. Other important determinants of serum cholesterol and triglycerides are the eating habits and the presence of regular physical activity. The risk of dyslipidaemia is significantly increased in the modern populations with high caloric intake and low exercise capacity. The main problem with dyslipidaemia is the fact that it is mostly an asymptomatic metabolic disorder. Therefore, it is crucial for the primary care physicians to know when, where and how to search for and how to manage the patient with dyslipidaemia.

In a patient with dyslipidaemia, the medical history should be taken for the possible diseases or drugs, which may cause secondary dyslipidaemia. A family history of premature atherosclerosis is crucial as it may help us recognize familial dyslipidaemias. Also, the lifestyle of the patient, including history of smoking or alcohol intake and exercise habits should carefully be sought. Also, the presence of effort angina, dyspnoea or claudication intermittence should be searched in the systemic examination of the patient. In the physical examination, the body mass index and arterial blood pressures should be measured and the peripheral pulses should be checked. Also the eye and cutaneous findings of dyslipidaemia should be searched during the physical examination. In order to rule out the secondary causes, fasting glucose levels, liver enzymes, creatine, urinary protein excretion and TSH levels should be seen in the laboratory evaluation process.