What are the symptoms of hyperlipidemia?

Generally speaking, the symptoms of hyperlipidemia are as follows:

1. When suffering from familial hypercholesterolemia, if the cholesterol content is too high, joint pain will occur.

The reason is that too much cholesterol forms a lump called "xanthoma", which will cause joint pain if it appears in the joint, but this situation is very rare and will only appear when the cholesterol content in the blood reaches a certain level.

Hyperlipidemia often develops for a long time without any symptoms unless it has developed into arteriosclerosis, which in turn leads to cardiovascular and cerebrovascular accidents. There are obvious symptoms at this time. But when these symptoms appear, most of them are already serious. Therefore, once diagnosed as hyperlipidemia, we should pay full attention to it. If you feel asymptomatic and do not receive further examination and treatment, you may develop into a life-threatening disease.

2. Back pain about 2 hours after meals.

Hyperlipidemia usually has no symptoms, but in a special case, if the triglyceride value exceeds 2.26 mmol/L, back pain may occur about 2 hours after meals, and the condition may turn into acute pancreatitis.

This also shows that the content of neutral fat in blood is rising, which has a lot to do with drinking and eating fatty foods. The pancreas is located behind the stomach. When food reaches the duodenum after a meal, the secretion function of the pancreas is the most vigorous, so pancreatitis is prone to occur about 2 hours after a meal, which is manifested as backache and backache. Therefore, if back pain occurs under the above circumstances, it should be suspected as pancreatitis, and blood lipid examination should be done in time.

3. Sometimes there will be symptoms of xanthoma. Having xanthoma is not necessarily hyperlipidemia, but if xanthoma and corneal wheel appear, it may be hyperlipidemia.

The most common xanthoma is a small yellow particle on the inside of eyelid, which is called xanthoma of eyelid. It is not necessarily hyperlipidemia to find xanthoma in the elderly population, but if xanthoma appears in young people under 40 years old, it may be hyperlipidemia and should be examined in detail immediately. Familial hypercholesterolemia is characterized by xanthoma on skin or tendon; The xanthoma of the skin often appears in joints such as elbow and knee; Xantoma of tendon is generally invisible, and tendon thickening can be felt only when diagnosed; Xantoma in the palm is rare, but it is a unique symptom of hyperlipidemia. In severe cases, the hand can't even hold things. When the concentration of triacylglycerol reaches tens of grams per liter, maculopapular xanthoma will appear on the buttocks and abdomen, showing a yellow bulge with a diameter of 2 ~ 3 mm.

Because the onset of hyperlipidemia is a chronic process, mild hyperlipidemia usually does not feel any discomfort, while severe hyperlipidemia may cause dizziness, headache, chest tightness, shortness of breath, palpitation, chest pain, fatigue, mouth tilt, inability to speak, limb numbness and other symptoms, which will eventually lead to serious diseases such as coronary heart disease and stroke, and sometimes directly threaten life.

the aged

The elderly often suffer from hyperlipidemia, which is closely related to atherosclerosis, coronary heart disease, diabetes and other senile diseases. According to some data in the United States, the levels of total cholesterol and triglycerides increase with age. According to the domestic literature, the total cholesterol, low-density lipoprotein cholesterol, triacylglycerol and apolipoprotein B in old people are obviously higher than those in young and middle-aged people, but they begin to decline after 80 years, and then fall to the level of young and middle-aged people after 90 years. However, high density lipoprotein and apolipoprotein A, which have protective effects on cardiovascular system, only slightly increase or even decrease from youth to old age, and only decrease after 80 years old. The changes of different blood lipid components with age also show that the anti-atherosclerosis ability of the elderly is obviously lower than that of the young. In addition, there are gender differences in blood lipids with age. Before the age of 50, men's total cholesterol and triglyceride levels were higher than those of women. After the age of 50, women often exceeded the average level of men, which may be related to the changes of estrogen levels before and after menopause.

The main reasons for the increase of blood lipid level with age are:

1. The ability of the elderly to metabolize lipids is reduced: the ability of the elderly to synthesize, degrade and transport cholesterol is reduced. Before the age of 55, blood cholesterol increased with age, and gradually decreased at the age of 60 ~ 70.

2. Impaired glucose tolerance: With the increase of age, the incidence of non-insulin-dependent diabetes mellitus increases, and the disorder of glucose metabolism in the body can lead to the increase of triglyceride and very low density lipoprotein levels in the elderly.

People with a family history of hyperlipidemia

Heredity can cause hyperlipidemia through many mechanisms, some of which can occur at the cellular level, mainly manifested in the defect of lipoprotein receptor on the cell surface and the defect of some enzymes in the cell (such as the defect or lack of lipase); It can also occur on lipoprotein or apolipoprotein molecules, mostly due to genetic defects. It is reported that the most common clinical disease in China is type II hyperlipoproteinemia, and dozens of patients of this type have been found in more than ten families in Shanghai alone.

Obese people

Besides physiological or pathological factors, obesity is mainly caused by too much fat intake and too little exercise consumption. It is generally believed that 10% of overweight people are overweight, over 20% are obese, over 30% are moderately obese, and over 50% are severely obese. Under normal circumstances, the complications of obese people are often accompanied by hyperlipidemia in addition to hypertension, diabetes and coronary heart disease.

No matter what causes obesity, it is caused by excessive increase of adipose tissue in the body. Although adipose tissue is one of the main sources of human energy, it contains 8% triacylglycerol. Although obese people sometimes have no abnormal changes in blood lipid analysis for the time being, long-term obesity often leads to lipid metabolism disorder.

Clinical observation shows that obesity is the most common secondary cause of blood triglyceride (TG) increase, and the blood cholesterol (Tc) content of some patients can also increase, mainly manifested as type ⅳ hyperlipidemia, followed by type ⅱ B hyperlipidemia.

smoker

The effects of smoking on blood lipids are as follows:

1. Increase the level of serum total cholesterol: Epidemiological studies have found that the level of serum total cholesterol of smokers is higher than that of non-smokers, and the concentration of carbon monoxide hemoglobin in their blood is as high as 10% ~ 20%, suggesting that the high level of serum total cholesterol may be related to the concentration of carbon monoxide in their blood.

2. Reduce serum high-density lipoprotein cholesterol: Many studies believe that smoking is negatively correlated with serum high-density lipoprotein cholesterol levels. The serum HDL cholesterol level of male and female smokers is 0. 1.3 ~ 0.23 mmol/L lower than that of non-smokers. A survey of premenopausal women aged 19 1 20-40 abroad found that the average serum HDL cholesterol level of smokers was 0. 18 mmol/L lower than that of non-smokers, and there was a significant difference between the two groups (P

3. Raise serum triglyceride: cigarettes contain a lot of nicotine and carbon monoxide, which can stimulate sympathetic nerve to release catecholamine, so that serum free fatty acids can be raised. Free fatty acids are finally absorbed by adipose tissue to form triglycerides, and catecholamine can promote the release of lipids from adipose tissue, which also leads to the increase of triglyceride levels.

4. Promote the oxidative modification of low-density lipoprotein: In recent years, experimental studies have found that low-density lipoprotein exposed to smoke is easily oxidized to form oxidized low-density lipoprotein, suggesting that carbon monoxide may increase the sensitivity of low-density lipoprotein to oxidative modification. Oxidized low density lipoprotein formed by oxidative modification is the main substance that directly leads to atherosclerosis.

People with hypothyroidism

When the content of thyroid hormone in serum is insufficient, the synthesis of cholesterol in liver increases. When hypothyroidism occurs, the activity of low-density lipoprotein receptor on hepatocyte membrane decreases, which can destroy the degradation pathway of low-density lipoprotein-dependent receptor in vivo, thus causing the increase of serum LDL-C and APOB levels. It has also been suggested that in hypothyroidism, the production rate of low-density lipoprotein in the body increases, which can also lead to the increase of serum LDL-C level.

When hypothyroidism occurs, the serum triglyceride concentration can be increased, normal or decreased. This may be related to the severity of hypothyroidism. The serum triglyceride level in severe patients often rises, which may be related to the increase of triglyceride synthesis in patients, but it may also be caused by triglyceride degradation. During hypothyroidism, lipoprotein lipase activity decreased, endogenous and exogenous fat clearance was inhibited, and the partial catabolism rate of triglycerides decreased to half of that of normal people.

diabetic

In human body, sugar metabolism and fat metabolism are closely related. Clinical studies have found that about 40% of diabetic patients can cause hyperlipidemia. Generally speaking, the metabolic disorder of chylomicron (CM) and very low density lipoprotein (VLDL) is the most common in patients with insulin-dependent diabetes mellitus (IDDM, type I). According to the severity of the disease, the above two lipoproteins are significantly increased in patients with severe insulin deficiency, especially ketoacidosis, showing type I and V hyperlipoproteinemia; Mild patients without ketosis may have no chylomicrons in the blood, and the very low density lipoprotein is normal or only slightly elevated, which may show type ⅳ hyperlipidemia. Non-insulin-dependent diabetes mellitus (NIDDM) is more common, and abnormal lipoprotein metabolism in patients with NIDDM may be related to obesity.

The ideal serum total cholesterol level of normal people in China is less than 5.2 mmol/L, while the ideal serum triglyceride level is 0.34-1.7 mmol/L.

The diagnostic criteria of hyperlipidemia in China are

Parameter plasma total cholesterol level plasma triglyceride level

Millimole/liter

Suitable range

Critical value 5.23 ~ 5.69

Rise > 5.72 & gt 1.70

It is necessary for patients with low HDL-C and hyperlipidemia to learn to understand the blood lipid test sheet, which can not only understand their own condition, but also play a guiding role in treatment.

The items of blood lipid examination in general hospitals mainly include:

TC: total cholesterol, also written as t-CHO.

TG: triglyceride

Hdl-c: high density lipoprotein cholesterol.

Ldl-c: low density lipoprotein cholesterol

Apolipoprotein A 1

APOB: apolipoprotein b

Normal value of each inspection:

Laboratory project

Standard value

Millimole/liter

Plasma total cholesterol (Tc)