Low HDL causes

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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, Danazol, 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

References

  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. PMID 20816133. doi:10.1016/j.amjcard.2010.05.013. 
  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. ISSN 0021-9738. doi:10.1172/JCI112332. 
  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. 
  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. PMC 3008575Freely accessible. PMID 20942659. doi:10.1056/NEJMoa1002926. 
  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. 
  6. Ito MK (2004). "The metabolic syndrome: pathophysiology, clinical relevance, and use of niacin.". Ann Pharmacother. 38 (2): 277–85. PMID 14742767. doi:10.1345/aph.1D218. 
  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. ISSN 0028-4793. doi:10.1056/NEJMcp044370. 
  8. Yamashita S, Matsuzawa Y (2009). "Where are we with probucol: a new life for an old drug?". Atherosclerosis. 207 (1): 16–23. PMID 19457483. doi:10.1016/j.atherosclerosis.2009.04.002. 
  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. PMID 15265253. doi:10.1185/030079904125004105. 

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