Agents Used in HyperlipidemiaVirtually all the lipids of humanplasma are transported as complexes withproteins. Except for fatty acids, which arebound chiefly to albumin, the lipids arecarried in special macromolecularcomplexes termed lipoproteins
1 Agents Used in Hyperlipidemia Virtually all the lipids of human plasma are transported as complexes with proteins. Except for fatty acids, which are bound chiefly to albumin, the lipids are carried in special macromolecular complexes termed lipoproteins
Definition:Hyperlipoproteinemias or HyperlipidemiasA numberof metabolic disorders thatinvolve elevations in plasma concentrationsof any of the lipoprotein species.Hyperlipemia is restricted to conditions thatinvolve increased levels of triglycerides inplasma2
2 Hyperlipoproteinemias or Hyperlipidemias: A number of metabolic disorders that involve elevations in plasma concentrations of any of the lipoprotein species. Hyperlipemia is restricted to conditions that involve increased levels of triglycerides in plasma. Definition：
Composition of the MajorLipoprotein Complexes·ChylomicronsThe low-density lipoproteins(LDL)Intermediate-density lipoproteins(IDL)Very low density lipoproteins(VLDL)High density lipoproteins (HDL)Lp(a) lipoproteins
3 Composition of the Major Lipoprotein Complexes • Chylomicrons • The low-density lipoproteins(LDL) • Intermediate-density lipoproteins(IDL) • Very low density lipoproteins(VLDL) • High density lipoproteins (HDL) • Lp(a) lipoproteins
Composition of theMajorLipoprotein ComplexesPLb%Cd%TGa%CEc%FFAe%ComplexSourceDensity (g/ml)Protein%3101-28ChylomicronIntestine<0.9585-881VLDLLiver12-158-100.95-1.0067-1050-5518-20IDL1VLDL10-1225-3025-2732358-101.006-1.0191IDLVLDL10-1520-288-101.019-1.06320-2237-4805-1532-4320-305-10*HDL21.063-1.12533-35Intestine.liver(chylomicronsandVLDLs)6HDL3Intestine,liver1.125-1.2155-573-1326-4615-302-6(chylomicronsandVLDLs)00000>1.2819901Albumin-FFAAdiposetissueaTriacylglycerols,bPhospholipids,cCholesteryl esters,dFree cholesteroleFree fatty acids*HDL2 and HDL3 derived from nascent HDL as a result of the acquisition ofcholesterylesters4
4 Complex Source Density (g/ml) Protein% TGa% PLb% CEc% Cd% FFAe % Chylomicron Intestine <0.95 1-2 85- 88 8 3 1 0 VLDL Liver 0.95-1.006 7-10 50-55 18 -20 12 -15 8 -10 1 IDL VLDL 1.006-1.019 10 -12 25 -30 25 -27 32 35 8 -10 1 IDL VLDL 1.019-1.063 20 -22 10 -15 20 -28 37 -48 8 -10 1 *HDL2 Intestine , liver (chylomicrons and VLDLs) 1.063-1.125 33 -35 5 -15 32 -43 20-30 5 -10 0 HDL3 Intestine, liver (chylomicrons and VLDLs) 1.125-1.21 55 -57 3 -13 26 -46 15 -30 2 -6 6 Albumin-FFA Adipose tissue >1.281 9901 0 0 0 0 0 Composition of the Major Lipoprotein Complexes aTriacylglycerols, bPhospholipids, cCholesteryl esters, dFree cholesterol, eFree fatty acids *HDL2 and HDL3 derived from nascent HDL as a result of the acquisition of cholesteryl esters
Clinical seguelaeAcute pancreatitisAcute pancreatitis occurs in patients with markedhyperlipemia. In such persons, control of triglyceridelevels can prevent recurrent attacks of this life-threatening disease.AtherosclerosisIt can accelerate development ofatherosclerosisthrombus,orinfarction.Plasma lipoproteins play an essential role inatherogenesis.5
5 Clinical sequelae ❖ Acute pancreatitis Acute pancreatitis occurs in patients with marked hyperlipemia. In such persons, control of triglyceride levels can prevent recurrent attacks of this lifethreatening disease. ❖ Atherosclerosis It can accelerate development of atherosclerosis, thrombus, or infarction. Plasma lipoproteins play an essential role in atherogenesis