Low HDL causes

	High Density Lipoprotein Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Low high-density lipoprotein (HDL) may be caused by familial (primary) or secondary conditions. Secondary causes of low HDL include physical inactivity, smoking, and diabetes mellitus.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

There are no life threatening causes of low HDL.

Common Causes

Causes by Organ System

Cardiovascular	Apo A-1 Giessen, apo A-1 Marburg, apo A-1 Milano, apo A-1 Munster, apolipoprotein C-11 deficiency, elevated cholesterylester transfer protein (CETP) activity, familial apo A-1 deficiency, familial combined hypolipidemia, familial deficiency of apo A-1 and apo C-111, familial HDL deficiency, familial hypertriglyceridaemia, familial hypoalphalipoproteinemia, familial lecithin-cholesterol acyltransferase (LCAT) deficiency, familial mixed hyperlipidaemia, high triglyceride, LDL receptor deficiency, lipoprotein lipase deficiency, metabolic syndrome, Reaven syndrome X, uncontrolled diabetes mellitus
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Anabolic steroids, androgens, atazanavir sulfate, atenolol, bendrofluazide, benzodiazepines, beta blockers, hydrochlorothiazide, lopinavir, Medroxyprogesterone acetate, probucol, progestins, propranolol, thiazide diuretics, tibolone
Ear Nose Throat	No underlying causes
Endocrine	Insulin resistance, metabolic syndrome, Reaven syndrome X, uncontrolled diabetes mellitus
Environmental	No underlying causes
Gastroenterologic	Severe liver disease
Genetic	Elevated cholesterylester transfer protein (CETP) activity, elevated hepatic triglyceride lipase activity, familial apo A-1 deficiency, familial combined hypolipidemia, familial deficiency of apo A-1 and apo C-111, familial HDL deficiency, familial hypertriglyceridaemia, familial hypoalphalipoproteinemia, familial lecithin-cholesterol acyltransferase (LCAT) deficiency, familial mixed hyperlipidaemia, Fish eye disease (partial LCAT deficiency), LDL receptor deficiency, lipoprotein lipase deficiency, metabolic syndrome, Niemann-Pick disease type B, Reaven syndrome X, sphingomyelinase deficiency, Tangier disease
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Niemann-Pick disease type B, sphingomyelinase deficiency
Nutritional/Metabolic	High carbohydrate diet, high triglyceride, malabsorption, malnutrition, metabolic syndrome, obesity, Reaven syndrome X, very low-fat diet
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	Fish eye disease (partial LCAT deficiency)
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Chronic renal failure, end-stage renal disease, nephrotic syndrome, uncontrolled diabetes mellitus
Rheumatology/Immunology/Allergy	Dysglobulinemia, gammopathies, severe inflammatory disease, metabolic syndrome, Reaven syndrome X
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Physical inactivity, smoking

Causes in Alphabetical Order

Anabolic steroids^[1]
Androgens
Apo A-1 Giessen
Apo A-1 Marburg
Apo A-1 Milano
Apo A-1 Munster
Apolipoprotein C-11 deficiency^[2]
Atazanavir sulfate
Atenolol
Bendrofluazide
Benzodiazepines
Beta blockers
Chronic renal failure
Dysglobulinemia^[3]
Elevated cholesterylester transfer protein (CETP) activity
Elevated hepatic triglyceride lipase activity
End-stage renal disease
Familial Apo A-1 deficiency
Familial combined hypolipidemia^[4]
Familial deficiency of Apo A-1 and Apo C-III^[5]
Familial HDL deficiency
Familial hypertriglyceridaemia
Familial hypoalphalipoproteinemia
Familial lecithin cholesterol acyltransferase (LCAT) deficiency
Familial mixed hyperlipidaemia
Fish eye disease (partial LCAT deficiency)
Gammopathies

References

↑ Achar S, Rostamian A, Narayan SM (2010). "Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm". Am J Cardiol. 106 (6): 893–901. doi:10.1016/j.amjcard.2010.05.013. PMID 20816133.
↑ Baggio, G; Manzato, E; Gabelli, C; Fellin, R; Martini, S; Enzi, G B; Verlato, F; Baiocchi, M R; Sprecher, D L; Kashyap, M L (1986). "Apolipoprotein C-II deficiency syndrome. Clinical features, lipoprotein characterization, lipase activity, and correction of hypertriglyceridemia after apolipoprotein C-II administration in two affected patients". Journal of Clinical Investigation. 77 (2): 520–527. doi:10.1172/JCI112332. ISSN 0021-9738.
↑ Cuisinier-Raynal JC, Bire F, Clerc M, Bernard J, Sarrouy J (1990). "[Human malaria: dysglobulinemia-hypocholesterolemia syndrome]". Med Trop (Mars). 50 (1): 91–5. PMID 2366654.
↑ Musunuru K, Pirruccello JP, Do R, Peloso GM, Guiducci C, Sougnez C; et al. (2010). "Exome sequencing, ANGPTL3 mutations, and familial combined hypolipidemia". N Engl J Med. 363 (23): 2220–7. doi:10.1056/NEJMoa1002926. PMC 3008575. PMID 20942659.
↑ Schaefer EJ, Ordovas JM, Law SW, Ghiselli G, Kashyap ML, Srivastava LS; et al. (1985). "Familial apolipoprotein A-I and C-III deficiency, variant II". J Lipid Res. 26 (9): 1089–101. PMID 3934306.
↑ Ito MK (2004). "The metabolic syndrome: pathophysiology, clinical relevance, and use of niacin". Ann Pharmacother. 38 (2): 277–85. doi:10.1345/aph.1D218. PMID 14742767.
↑ ^7.0 ^7.1 ^7.2 Ashen, M. Dominique; Blumenthal, Roger S. (2005). "Low HDL Cholesterol Levels". New England Journal of Medicine. 353 (12): 1252–1260. doi:10.1056/NEJMcp044370. ISSN 0028-4793.
↑ Yamashita S, Matsuzawa Y (2009). "Where are we with probucol: a new life for an old drug?". Atherosclerosis. 207 (1): 16–23. doi:10.1016/j.atherosclerosis.2009.04.002. PMID 19457483.
↑ Miller M, Dobs A, Yuan Z, Battisti WP, Borisute H, Palmisano J (2004). "Effectiveness of simvastatin therapy in raising HDL-C in patients with type 2 diabetes and low HDL-C". Curr Med Res Opin. 20 (7): 1087–94. doi:10.1185/030079904125004105. PMID 15265253.

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[pmid20816133-1] Achar S, Rostamian A, Narayan SM (2010). "Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm". Am J Cardiol. 106 (6): 893–901. doi:10.1016/j.amjcard.2010.05.013. PMID 20816133.

[BaggioManzato1986-2] Baggio, G; Manzato, E; Gabelli, C; Fellin, R; Martini, S; Enzi, G B; Verlato, F; Baiocchi, M R; Sprecher, D L; Kashyap, M L (1986). "Apolipoprotein C-II deficiency syndrome. Clinical features, lipoprotein characterization, lipase activity, and correction of hypertriglyceridemia after apolipoprotein C-II administration in two affected patients". Journal of Clinical Investigation. 77 (2): 520–527. doi:10.1172/JCI112332. ISSN 0021-9738.

[pmid2366654-3] Cuisinier-Raynal JC, Bire F, Clerc M, Bernard J, Sarrouy J (1990). "[Human malaria: dysglobulinemia-hypocholesterolemia syndrome]". Med Trop (Mars). 50 (1): 91–5. PMID 2366654.

[pmid20942659-4] Musunuru K, Pirruccello JP, Do R, Peloso GM, Guiducci C, Sougnez C; et al. (2010). "Exome sequencing, ANGPTL3 mutations, and familial combined hypolipidemia". N Engl J Med. 363 (23): 2220–7. doi:10.1056/NEJMoa1002926. PMC 3008575. PMID 20942659.

[pmid3934306-5] Schaefer EJ, Ordovas JM, Law SW, Ghiselli G, Kashyap ML, Srivastava LS; et al. (1985). "Familial apolipoprotein A-I and C-III deficiency, variant II". J Lipid Res. 26 (9): 1089–101. PMID 3934306.

[pmid14742767-6] Ito MK (2004). "The metabolic syndrome: pathophysiology, clinical relevance, and use of niacin". Ann Pharmacother. 38 (2): 277–85. doi:10.1345/aph.1D218. PMID 14742767.

[AshenBlumenthal2005-7] 7.0 ^7.1 ^7.2 Ashen, M. Dominique; Blumenthal, Roger S. (2005). "Low HDL Cholesterol Levels". New England Journal of Medicine. 353 (12): 1252–1260. doi:10.1056/NEJMcp044370. ISSN 0028-4793.

[pmid19457483-8] Yamashita S, Matsuzawa Y (2009). "Where are we with probucol: a new life for an old drug?". Atherosclerosis. 207 (1): 16–23. doi:10.1016/j.atherosclerosis.2009.04.002. PMID 19457483.

[pmid15265253-9] Miller M, Dobs A, Yuan Z, Battisti WP, Borisute H, Palmisano J (2004). "Effectiveness of simvastatin therapy in raising HDL-C in patients with type 2 diabetes and low HDL-C". Curr Med Res Opin. 20 (7): 1087–94. doi:10.1185/030079904125004105. PMID 15265253.

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v t e Lipopedia
Basic Science	Cholesterol • Triglyceride Lipoprotein metabolism and transport Lipoprotein: Chylomicron • Chylomicron remnant • HDL • IDL • LDL • Lipoprotein(a) • VLDL • Lipoprotein-X Apolipoprotein: APOA (1, 2, 4, 5) • APOB ( Apolipoprotein B-48, Apolipoprotein B-100) • APOC (1, 2, 3, 4) • APOD • APOE • APOH • APOJ • APOL • APOM • Apo(a) Lipoprotein receptor: LDL receptor • Soluble low density lipoprotein receptor-related protein (sLRP) • Apolipoprotein E Receptor 2 • Scavenger receptor • Scavenger receptor A • Scavenger receptor B • VLDL receptor Lipoprotein enzymes: Lipoprotein lipase • Lipoprotein-associated phospholipase A2 (Lp-PLA2) • Cholesterylester transfer protein ( Acetyl-CoA C-acyltransferase, Lecithin-cholesterol acyltransferase) • Microsomal triglyceride transfer protein • ABCA1 Genes: Low density lipoprotein receptor gene family • Microsomal triglyceride transfer protein • ABCA1
Lipoprotein Disorders	Lipoprotein disorders Primary lipoprotein disorders: Familial hyperchylomicronemia (Type I) • Familial hypercholesterolemia (Type IIA) • Familial combined hyperlipidemia (Type IIB) • Dysbetalipoproteinemia (Type III) • Primary hypertriglyceridemia (Type IV) • Mixed hyperlipoproteinemia (Type V) Secondary lipoprotein disorders
Abnormal Laboratory Lipid Profile	Low chylomicron • Low chylomicron remnant • Low HDL • Low IDL • Low LDL • Low lipoprotein(a) • Low VLDL High chylomicron • High chylomicron remnant • High HDL • High IDL • High LDL • High Lipoprotein(a) • High VLDL