Adipositas - Ursachen, Folgeerkrankungen, Therapie 2017; 11(02): 81-86
DOI: 10.1055/s-0037-1618961
Übersichtsarbeit 81
Schattauer GmbH

Lipid metabolism: Diagnosis, evaluation and treatment of primary dislipidemia

Article in several languages: deutsch | EnglishG. Klose1, W. März2, 3, 4
  • 1Dres.T. Beckenbauer & S. Maierhof, Gastroenterologie & Kardiologie, Bremen, und Dres. I.van de Loo & K. Spieker, Endokrinologie Diabetologe DDG, Diabetes-Schwerpunktpraxis, Bremen
  • 2Medizinische Klinik V (Nephrologie, Hypertensiologie, Rheumatologie, Endokrinologie, Diabetelogie), Medizinische Fakultät Mannheim der Universität Heidelberg
  • 3Klinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität Graz, Österreich
  • 4Syn-lab Akademie, synlab Holding Deutschland GmbH, Mannheim und Augsburg
Further Information

Publication History

Publication Date:
29 December 2017 (online)

Summary

Dyslipidemias are clinically relevant as a major causal factor for atherosclerosis-related diseases and in the case of severe hypertriglyceridemia as trigger of pancreatitis. The treatment of genetic dyslipidemia is based on its pathogenesis and clinical consequence. New findings opened options that go beyond the treatment with statins. This includes RCT-evidence for the cholesterol absorption inhibitor ezetimibe and PCSK9 inhibition. Now proof exists that both approaches reduce the rate of clinical endpoints in addition to standard therapy. The clinical development of Antisense Oligonucleotides for the reduction of Apo (a) and Apo C3 may lead to improved treatments for severe hypertriglyceridemia and pathological increases of Lp(a) soon. Dyslipidemias are changes of the concentration or the composition of one or more lipoprotein classes in the plasma. Classifications of lipid disorders usually are based on the preponderance of hypercholesterolemia or hypertriglyceridemia and etiological factors, i.e. primary or secondary dyslipidemia. The most practical significance has the coverage and treatment of dyslipidemias as cardiovascular risk factor. Treatment recommendations in current guidelines are not based on deviations from normal values but depend on estimations of cardiovascular risk. Diagnosis and treatment of dyslipidemias in which a genetic diagnosis is accessible are the focus of this review because they provide essential indications for the now possible, but also cost intensive lipid-lowering treatment options.