Hypolipoproteinemia pathophysiology: Difference between revisions
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In primary hypolipedemia, genetic mutations cause an underproduction or increased clearance of [[Low Density Lipoproteins]] (LDL) and result in lipid levels low enough to cause significant consequences. | In primary hypolipedemia, genetic mutations cause an underproduction or increased clearance of [[Low Density Lipoproteins]] (LDL) and result in lipid levels low enough to cause significant consequences. | ||
In anemia | *In anemia: | ||
Mechanisms suggested that high-erythropoitic activity-associated hypocholesterolemia is due to increased cholesterol requirements by the proliferating erythoid cells.<ref name="pmid17039515">{{cite journal| author=Shalev H, Kapelushnik J, Moser A, Knobler H, Tamary H| title=Hypocholesterolemia in chronic anemias with increased erythropoietic activity. | journal=Am J Hematol | year= 2007 | volume= 82 | issue= 3 | pages= 199-202 | pmid=17039515 | doi=10.1002/ajh.20804 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17039515 }} </ref> | |||
*In hyperthyroidism: | |||
Thyroid hormone dysfunction affect composition and transport of lipoproteins,<ref name="pmid17018450">{{cite journal| author=Liberopoulos EN, Elisaf MS| title=Dyslipidemia in patients with thyroid disorders. | journal=Hormones (Athens) | year= 2002 | volume= 1 | issue= 4 | pages= 218-23 | pmid=17018450 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17018450 }} </ref> Moreover, the triiodothyronine (T3) enhances the gene expression of the LDL receptor and hence the receptor activity.<ref name="pmid17018450">{{cite journal| author=Liberopoulos EN, Elisaf MS| title=Dyslipidemia in patients with thyroid disorders. | journal=Hormones (Athens) | year= 2002 | volume= 1 | issue= 4 | pages= 218-23 | pmid=17018450 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17018450 }} </ref> | |||
*In critical illness: | |||
Downregulation of hepatic synthesis due to decreased production of cholesterol precursors particularly lanosterol and lathosterol.<ref name="pmid14743581">{{cite journal| author=Bakalar B, Hyspler R, Pachl J, Zadak Z| title=Changes in cholesterol and its precursors during the first days after major trauma. | journal=Wien Klin Wochenschr | year= 2003 | volume= 115 | issue= 21-22 | pages= 775-9 | pmid=14743581 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14743581 }} </ref><ref name="pmid10470581">{{cite journal| author=Giovannini I, Boldrini G, Chiarla C, Giuliante F, Vellone M, Nuzzo G| title=Pathophysiologic correlates of hypocholesterolemia in critically ill surgical patients. | journal=Intensive Care Med | year= 1999 | volume= 25 | issue= 7 | pages= 748-51 | pmid=10470581 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10470581 }} </ref> Other different mechanisms include loss of apoproteins in burns, increased cholesterol catabolism, and Low cholesterol concentrations associated with high levels of cytokines such as interleukin (IL)-6 and IL-10 may be involved.<ref name="pmid7431454">{{cite journal| author=Coombes EJ, Shakespeare PG, Batstone GF| title=Lipoprotein changes after burn injury in man. | journal=J Trauma | year= 1980 | volume= 20 | issue= 11 | pages= 971-5 | pmid=7431454 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7431454 }} </ref><ref name="pmid10470581">{{cite journal| author=Giovannini I, Boldrini G, Chiarla C, Giuliante F, Vellone M, Nuzzo G| title=Pathophysiologic correlates of hypocholesterolemia in critically ill surgical patients. | journal=Intensive Care Med | year= 1999 | volume= 25 | issue= 7 | pages= 748-51 | pmid=10470581 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10470581 }} </ref><ref name="pmid15142422">{{cite journal| author=Bonville DA, Parker TS, Levine DM, Gordon BR, Hydo LJ, Eachempati SR et al.| title=The relationships of hypocholesterolemia to cytokine concentrations and mortality in critically ill patients with systemic inflammatory response syndrome. | journal=Surg Infect (Larchmt) | year= 2004 | volume= 5 | issue= 1 | pages= 39-49 | pmid=15142422 | doi=10.1089/109629604773860291 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15142422 }} </ref> | |||
*In malignancy: | |||
Elevated LDL receptor activity in malignant cells may be a contributing factor to hypocholesterolemia in some cancer patients.<ref name="pmid4068801">{{cite journal| author=Peterson C, Vitols S, Rudling M, Blomgren H, Edsmyr F, Skoog L| title=Hypocholesterolemia in cancer patients may be caused by elevated LDL receptor activities in malignant cells. | journal=Med Oncol Tumor Pharmacother | year= 1985 | volume= 2 | issue= 3 | pages= 143-7 | pmid=4068801 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4068801 }} </ref> | |||
Revision as of 22:13, 12 September 2013
Template:Hypolipidemia Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]
Pathophysiology
Multiple mechanisms have been described in different diseases and clinical conditions that are found to be associated with hypolipidemia. In primary hypolipedemia, genetic mutations cause an underproduction or increased clearance of Low Density Lipoproteins (LDL) and result in lipid levels low enough to cause significant consequences.
- In anemia:
Mechanisms suggested that high-erythropoitic activity-associated hypocholesterolemia is due to increased cholesterol requirements by the proliferating erythoid cells.[1]
- In hyperthyroidism:
Thyroid hormone dysfunction affect composition and transport of lipoproteins,[2] Moreover, the triiodothyronine (T3) enhances the gene expression of the LDL receptor and hence the receptor activity.[2]
- In critical illness:
Downregulation of hepatic synthesis due to decreased production of cholesterol precursors particularly lanosterol and lathosterol.[3][4] Other different mechanisms include loss of apoproteins in burns, increased cholesterol catabolism, and Low cholesterol concentrations associated with high levels of cytokines such as interleukin (IL)-6 and IL-10 may be involved.[5][4][6]
- In malignancy:
Elevated LDL receptor activity in malignant cells may be a contributing factor to hypocholesterolemia in some cancer patients.[7]
References
- ↑ Shalev H, Kapelushnik J, Moser A, Knobler H, Tamary H (2007). "Hypocholesterolemia in chronic anemias with increased erythropoietic activity". Am J Hematol. 82 (3): 199–202. doi:10.1002/ajh.20804. PMID 17039515.
- ↑ 2.0 2.1 Liberopoulos EN, Elisaf MS (2002). "Dyslipidemia in patients with thyroid disorders". Hormones (Athens). 1 (4): 218–23. PMID 17018450.
- ↑ Bakalar B, Hyspler R, Pachl J, Zadak Z (2003). "Changes in cholesterol and its precursors during the first days after major trauma". Wien Klin Wochenschr. 115 (21–22): 775–9. PMID 14743581.
- ↑ 4.0 4.1 Giovannini I, Boldrini G, Chiarla C, Giuliante F, Vellone M, Nuzzo G (1999). "Pathophysiologic correlates of hypocholesterolemia in critically ill surgical patients". Intensive Care Med. 25 (7): 748–51. PMID 10470581.
- ↑ Coombes EJ, Shakespeare PG, Batstone GF (1980). "Lipoprotein changes after burn injury in man". J Trauma. 20 (11): 971–5. PMID 7431454.
- ↑ Bonville DA, Parker TS, Levine DM, Gordon BR, Hydo LJ, Eachempati SR; et al. (2004). "The relationships of hypocholesterolemia to cytokine concentrations and mortality in critically ill patients with systemic inflammatory response syndrome". Surg Infect (Larchmt). 5 (1): 39–49. doi:10.1089/109629604773860291. PMID 15142422.
- ↑ Peterson C, Vitols S, Rudling M, Blomgren H, Edsmyr F, Skoog L (1985). "Hypocholesterolemia in cancer patients may be caused by elevated LDL receptor activities in malignant cells". Med Oncol Tumor Pharmacother. 2 (3): 143–7. PMID 4068801.