dislipidemie

Dyslipidemia, also called dislipidemie in some languages, refers to abnormal levels of lipids in the blood. It encompasses elevated low-density lipoprotein cholesterol (LDL-C), elevated triglycerides, and low high-density lipoprotein cholesterol (HDL-C), or combinations of these abnormalities. Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease (ASCVD) and, in severe hypertriglyceridemia, for pancreatitis.

Causes include primary (genetic) disorders such as familial hypercholesterolemia and familial combined hyperlipidemia, as well as secondary factors such as obesity, type 2 diabetes, hypothyroidism, nephrotic syndrome, liver disease, kidney disease, and certain medications (steroids, antipsychotics, immunosuppressants).

Diagnosis is based on a lipid panel measuring total cholesterol, LDL-C, HDL-C, and triglycerides. Thresholds are guideline-dependent, but generally elevated LDL-C or triglycerides identify individuals at increased cardiovascular risk. Nonfasting samples are increasingly used, with triglycerides especially sensitive to recent meals. In suspected familial cases, genetic testing and family screening may be appropriate.

Management focuses on reducing ASCVD risk through lifestyle modification—balanced diet with limited saturated fat and refined carbohydrates, regular physical activity, weight management, and smoking cessation. Pharmacotherapy is chosen based on risk and lipid pattern: statins are first-line; ezetimibe or PCSK9 inhibitors can be added for insufficient response; bempedoic acid is another option. For severe hypertriglyceridemia, fibrates or high-dose omega-3 fatty acids may be used. Regular monitoring of lipid levels and potential adverse effects is recommended.

Prognosis improves with early detection and sustained lipid-lowering therapy. Family screening is advised for inherited forms of dyslipidemia.