Disorders of lipid metabolism B.Pharmacy 2nd Semester 2022 (2021-2022) Previous Year's Question Papers/Notes Download - HK Technical PGIMS

Disorders of lipid metabolism
Hypercholesterolemia:
• It is characterized by the increased levels of cholesterol in blood. It is also called as high
cholesterol.
• It is a form of hyperlipidemia (high blood lipids) and, hyperlipoproteinemia(elevated levels of
lipoproteins in the blood.
Hypercholesterolemia is associated with cardiovascular diseases particularly coronary heart
disease.
• By measuring the levels of HDL and LDL we can predict future coronary heart diseases.
• It occurs 1in 200 to 1in 250 people in most of the countries.
Causes:
• Combination of both environmental and genetic factors.
• Diabetes mellitus, obesity, hypothyroidism, Cushing’s syndrome, alcohol use.
• Single defective gene can also leads to familial hypercholesterolemia.
Symptoms:
Heart diseases, chest pain, heart attack, small bumps on skin, hands, elbows, peripheral artery
diseases, stroke, dizziness…etc
Symptoms of familial hypercholesterolemia includes; chest pain with activity, xanthomas(fatty
deposits found in tendons and on elbows and knees), cholesterol deposits around eyelids.
Medications:
• Use of statins reduces total cholesterol in 50% of majority of the people. These are very
effective in reducing the coronary heart diseases.
• By using high intensity Statin therapy we can adopt higher benefits.
• Statin usage is not mandatory in children’s ,instead diet control is main therapy
Fatty liver:
• Fatty liver refers to the deposition of excess fatty acids or triglycerides in the liver cells.
• Causes:
1. Excessive mobilization of fat: the capacity of liver to take up the fatty acids from blood
far exceeds its capacity for excretion as VLDL. So fatty liver can occur in diabetes
mellitus and starvation due to increased lipolysis in adipose tissue.
2. Excessive calorie intake: excess calories, either in the form of carbohydrates or as fats,
are deposited as fat. Hence obesity may be accompanied by fatty liver.
3. Toxic injury to liver: any toxic injury to the liver results in reduced removal of from
liver.
4. Hepatitis B virus infection also reduces the function of hepatic cells.
5. Alcoholism: it is the most common cause of fatty liver and cirrhosis.
6. Non alcoholic fatty liver disease is the most common liver disease, where fat is
accumulated in hepatocytes. High fat diet and uncontrolled DM are the most common
causes
7. High blood sugar levels.
8. Insulin resistance
Diagnosis:
In many cases, fatty liver disease is diagnosed after blood tests. Elevated levels of liver
enzymes (ALT and AST) are the signs of liver inflammation.
Liver biopsy: is the best way to determine the severity of liver disease. During liver biopsy,
doctor will insert a needle into the liver and remove a piece of tissue for examination. This
test can helps to determine the fatty liver disease.
Treatment:
Intake of nutrient rich diet that’s low in excess calories, saturated fat and trans fat.
Exercise
Limit alcohol intake
Maintenance of body weight
Atherosclerosis
▪ The normal level of blood cholesterol is 140-250 mg/dl.
▪ High levels of cholesterol lead to atherosclerosis, characterized by the deposition of
cholesterol esters and other lipids in connective tissue of arterial walls.
▪ Diet rich in saturated fatty acids increases the plasma cholesterol. Replacement of
saturated with a fat that is rich in PUFA’S such as linoleic acid decreases plasma
cholesterol.
▪ Corn oil, cotton seed oil ,peanut oil lowers the blood cholesterol. butter fat and
coconut oil raises cholesterol.
Conditions for atherosclerosis to occur are:
▪ Elevated levels of cholesterol and LDL.
▪ Decreased levels of HDL.
▪ The normal ratio of LDL to HDL is 3-3.6. if the ratio is greater than 3.6 ;the
risk of myocardial infaraction is more.if the ratio is less than 3.0 the risk is
less.
➢ HDL cholesterol is a good cholesterol because it has a major role in the removal of
cholesterol from peripheral extra hepatic tissues and transport cholesterol to the liver
where it is metabolized to form bile acids. This action is called as scavenging action of
cholesterol. Due to this atherosclerosis is prevented.
➢ Risk of atherosclerosis is less , if
• LDL Cholesterol is less
• HDL Cholesterol is more.
LDL cholesterol can be minimized by
• Avoiding animal fats and hydrogenated/saturated fats.
• Taking vegetable seed oils containing PUFA like groundnut oil, sunflower oil
ginger oil etc.
• Consuming dietary fibers
Obesity
It is a complex disease characterized by excessive body fat that increases the risk of heart problems.
Causes –
The most common causes of obesity are
1. Over eating
2. Physical inactivity
3. Lack of exercise
4. It is a medical problem that increases the risk of other diseases and health problems such as
heart diseases, diabetes, high Blood pressure and certain cancers.
5. Genetic problems
6. Diseases such as hyper thyroidism polycystic overy syndrome are also contributes obesity.
7. Diet rich in fat
Diagnosis
1. Physical Examination and Blood tests
Treatment
2. Healthy meal planning
3. Regular physical activity
4. Intake of diet with less fat content
5. Weight loss medicines
6. Weight loss devices, special diets etc.,
Symptoms may includes
1. over weight
2. Abdominal obesity
3. Back pain
4. Increased sweating
5. Snoring
6. Back and joint pains
7. Low confidence
8. Shortness of breath
9. Trouble sleeping
10. Psychological problems such as depression, shame etc.,
11. Skin problems
12. Excess of fat accumulation