Hypolipoproteinemia pathophysiology
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, the suggested mechanism 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]
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.