Düslipideemia

Düslipideemia, or dyslipidemia, is a medical condition characterized by abnormal levels of lipids in the blood. It commonly involves elevated low-density lipoprotein cholesterol (LDL-C), elevated triglycerides (TG), and/or reduced high-density lipoprotein cholesterol (HDL-C). The condition is a major risk factor for cardiovascular disease and, in cases of markedly high triglycerides, can increase the risk of pancreatitis.

Causes and classification may be genetic (primary) or acquired (secondary). Primary forms include familial hypercholesterolemia and other inherited lipid disorders. Secondary causes include obesity, insulin resistance or diabetes, hypothyroidism, nephrotic syndrome, chronic kidney or liver disease, smoking, poor diet, physical inactivity, and certain medications. Lipid abnormalities are often categorized by the dominant lipid abnormality: high LDL-C, high TG, low HDL-C, or a combination (mixed dyslipidemia).

Diagnosis is based on a lipid panel typically including total cholesterol, LDL-C, HDL-C, and triglycerides. LDL-C is often calculated using the Friedewald equation when triglycerides are below 400 mg/dL (4.5 mmol/L); non-HDL-C and apolipoprotein B can provide additional risk information. Results are interpreted in the context of overall ASCVD risk, and targets may vary by age, sex, and cardiovascular risk level.

Management focuses on reducing cardiovascular risk. Lifestyle changes—dietary modification (reducing saturated fat and refined carbohydrates), weight loss, regular physical activity, and smoking cessation—are foundational. Pharmacotherapy commonly begins with statins; alternatives include ezetimibe, PCSK9 inhibitors, bempedoic acid, and fibrates for elevated triglycerides. Omega-3 fatty acids may be used for severe hypertriglyceridemia. Regular follow-up lipid testing guides therapy adjustments and monitoring for adverse effects.