Lipidology

Lipidology is the medical subspecialty focused on lipids and lipoproteins, their metabolism, and related disorders. It covers assessment, diagnosis, prevention, and treatment of dyslipidemias and lipid-related cardiovascular risk, integrating laboratory science, genetics, pharmacology, and lifestyle medicine. Clinicians who practice lipidology may come from internal medicine, cardiology, endocrinology, or pediatrics, and often collaborate with dietitians and genetic counselors.

Lipid transport in the blood involves lipoproteins such as chylomicrons, VLDL, LDL, and HDL. The major lipid metrics include total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. Apolipoprotein B and lipoprotein(a) are also used in risk assessment. Abnormal levels contribute to atherosclerotic cardiovascular disease, pancreatitis in cases of severe hypertriglyceridemia, or other disorders.

Diagnostic evaluation includes fasting lipid panel, repeat measurements, and targeted tests for genetic disorders like familial hypercholesterolemia. Advanced lipid testing may assess LDL particle number, size, and apoB, though routine use varies by guidelines. Risk assessment often employs non-HDL cholesterol and apoB in addition to traditional metrics.

Management emphasizes lifestyle modification and pharmacotherapy to reduce cardiovascular risk. First-line pharmacotherapy typically includes statins, with alternatives such as ezetimibe, PCSK9 inhibitors, bempedoic acid, fibrates, omega-3 fatty acids, or combination therapy as indicated. Guidelines from professional societies guide treatment targets based on overall risk. Research in lipidomics and emerging therapies continues to refine diagnosis and therapy.