Hypolipoproteinemia pathophysiology: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 18: Line 18:
*In malignancy:
*In malignancy:
Elevated LDL receptor activity in malignant cells may be a contributing factor to hypocholesterolemia in some cancer patients.<ref name="pmid4068801">{{cite journal| author=Peterson C, Vitols S, Rudling M, Blomgren H, Edsmyr F, Skoog L| title=Hypocholesterolemia in cancer patients may be caused by elevated LDL receptor activities in malignant cells. | journal=Med Oncol Tumor Pharmacother | year= 1985 | volume= 2 | issue= 3 | pages= 143-7 | pmid=4068801 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4068801  }} </ref>
Elevated LDL receptor activity in malignant cells may be a contributing factor to hypocholesterolemia in some cancer patients.<ref name="pmid4068801">{{cite journal| author=Peterson C, Vitols S, Rudling M, Blomgren H, Edsmyr F, Skoog L| title=Hypocholesterolemia in cancer patients may be caused by elevated LDL receptor activities in malignant cells. | journal=Med Oncol Tumor Pharmacother | year= 1985 | volume= 2 | issue= 3 | pages= 143-7 | pmid=4068801 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4068801  }} </ref>
*In Malabsorption:
The loss of the main source of exogenous fat can lead to hypolipidemia.<ref name="pmid16945614">{{cite journal| author=Brar P, Kwon GY, Holleran S, Bai D, Tall AR, Ramakrishnan R et al.| title=Change in lipid profile in celiac disease: beneficial effect of gluten-free diet. | journal=Am J Med | year= 2006 | volume= 119 | issue= 9 | pages= 786-90 | pmid=16945614 | doi=10.1016/j.amjmed.2005.12.025 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16945614  }} </ref>
*In infection:
The chronic effect of proinflammatory cytokines on lipoprotein metabolism, which is mediated by different cytokines as IL-1 and tumor necrosis factor-alpha (TNF) which are involved in the acute phase response during sepsis.<ref name="pmid9775136">{{cite journal| author=Bentz MH, Magnette J| title=[Hypocholesterolemia during the acute phase of an inflammatory reaction of infectious origin. 120 cases]. | journal=Rev Med Interne | year= 1998 | volume= 19 | issue= 3 | pages= 168-72 | pmid=9775136 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9775136  }} </ref>  It has been observed that Convalescing patients ready discharge have improved cholesterol levels, whereas dying patients appear to have progressive hypocholesterolemia.<ref name="pmid14624689">{{cite journal| author=Dunham CM, Fealk MH, Sever WE| title=Following severe injury, hypocholesterolemia improves with convalescence but persists with organ failure or onset of infection. | journal=Crit Care | year= 2003 | volume= 7 | issue= 6 | pages= R145-53 | pmid=14624689 | doi=10.1186/cc2382 | pmc=PMC374375 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14624689  }} </ref>





Revision as of 22:37, 12 September 2013

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:

Mechanisms 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]

  • In malignancy:

Elevated LDL receptor activity in malignant cells may be a contributing factor to hypocholesterolemia in some cancer patients.[7]

  • In Malabsorption:

The loss of the main source of exogenous fat can lead to hypolipidemia.[8]

  • In infection:

The chronic effect of proinflammatory cytokines on lipoprotein metabolism, which is mediated by different cytokines as IL-1 and tumor necrosis factor-alpha (TNF) which are involved in the acute phase response during sepsis.[9] It has been observed that Convalescing patients ready discharge have improved cholesterol levels, whereas dying patients appear to have progressive hypocholesterolemia.[10]







References

  1. 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. 2.0 2.1 Liberopoulos EN, Elisaf MS (2002). "Dyslipidemia in patients with thyroid disorders". Hormones (Athens). 1 (4): 218–23. PMID 17018450.
  3. 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. 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.
  5. Coombes EJ, Shakespeare PG, Batstone GF (1980). "Lipoprotein changes after burn injury in man". J Trauma. 20 (11): 971–5. PMID 7431454.
  6. 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.
  7. Peterson C, Vitols S, Rudling M, Blomgren H, Edsmyr F, Skoog L (1985). "Hypocholesterolemia in cancer patients may be caused by elevated LDL receptor activities in malignant cells". Med Oncol Tumor Pharmacother. 2 (3): 143–7. PMID 4068801.
  8. Brar P, Kwon GY, Holleran S, Bai D, Tall AR, Ramakrishnan R; et al. (2006). "Change in lipid profile in celiac disease: beneficial effect of gluten-free diet". Am J Med. 119 (9): 786–90. doi:10.1016/j.amjmed.2005.12.025. PMID 16945614.
  9. Bentz MH, Magnette J (1998). "[Hypocholesterolemia during the acute phase of an inflammatory reaction of infectious origin. 120 cases]". Rev Med Interne. 19 (3): 168–72. PMID 9775136.
  10. Dunham CM, Fealk MH, Sever WE (2003). "Following severe injury, hypocholesterolemia improves with convalescence but persists with organ failure or onset of infection". Crit Care. 7 (6): R145–53. doi:10.1186/cc2382. PMC 374375. PMID 14624689.

Template:WH Template:WS