老年病学英文课件：Dyslipidemia in elderly

• Cholesterol travels in the blood in distinct particles containing both lipid and proteins known as lipoproteins.
• There major classes of lipoproteins are found in the serum of a fasting individual: low density lipoproteins (LDL), high density lipoproteins (HDL), and very low density lipoproteins (VLDL).
• It may be classifieds as:
– Hypercholesterolemia – Low levels of high density lipoproteins (HDL) – Hypertriglyceridemia
National Cholesterol Education Program Adult Treatment Panel III Approach to
• Not all experts are convinced that apoB should be routinely measure and therefore, they are considered secondary and optional targets.
High Density Lipoprotein (HDL):
Dyslipidemia in elderly
Definitions
• Dyslipidemia: is a diagnosis of “abnormal lipid levels”, as measured on a blood sample and which reflects one of several disorders in the metabolism of lipoproteins.
• LDL is the major atherogenic lipoprotein and has long been identified by the National Cholesterol Education Program (NCEP) as the primary target of cholesterol lowering therapy; the alternate primary target is apoB.
Low Density Lipoprotein (LDL)
• is commonly referred to as “bad” cholesterol. It typically makes up 60-70% of the total serum cholesterol and contains a single apolipoprotein, namely apolipoprotein B (apo B).
• is commonly referred to as “good” cholesterol. It makes up approximately 20-30% of the total serum cholesterol with highest level of protein.
• HDL cholesterol levels are inversely correlated with risk for Cardiovascular Disease (CVD). Some evidence indicated that HDL protects against the development of atherosclerosis, although a low HDL level often reflects the presence of other atherogenic factors.
< 100 (< 2.58)
Optimal
100–129 (2.58–3.33)
Near optim4.11) 160–189 (4.13–4.88) ≥ 190 (≥ 4.91) HDL cholesterol < 40 (< 1.03) ≥ 60 (≥ 1.55) TG < 150 (< 1.695) 150–199 (1.695–2.249) 200–499 (2.26–5.639) ≥ 500 (≥ 5.65)
Lipoprotein
• lipid particles surrounded by proteins transport cholesterol within the body.
• Each lipoprotein is a combination of triglyceride, cholesterol and protein unique to its type.
Dyslipidemias
1. Measure fasting lipoproteins (in mg/dL):
TC (mmol/L)
< 200 (< 5.17)
Desirable
200–239 (5.17–6.18)
Borderline high
≥ 240 (≥ 6.20)
High
LDL cholesterol
• Based on evidence, many experts have concluded that apoB is a better test by providing a better indication of vascular disease than LDL-C, a better index of how LDL therapy is working and less laboratory errors than the LDL-C.
Borderline high High Very high
Low High
Desirable Borderline high High Very high
Cholesterol
• A fat-like substance (lipid) that is present in cell membranes and is a precursor of bile acids and steroid hormones.