Causes, symptoms and treatment of lipid metabolism disorders. Lipid metabolism disorder

>>> To effectively lose weight, once and for all, you need to correct lipid metabolism

Hyperlipidemia is found in 10-20% of children and 40-60% of adults and requires special research. The need for hyperlipidemia research is driven by four important clinical circumstances.

The first is the cause-and-effect relationship between hyperlipidemia and atherosclerotic vascular lesions, manifested by coronary heart disease, strokes, atherosclerosis of the vessels of internal organs and peripheral vascular diseases.

The second circumstance is the direct correlation that exists between hyperlipidemia and the frequency of xanthomatosis of the skin and tendons.

Thirdly, abdominal pain unknown etiology and fourth, hyperlipidemia may indicate another disease, such as hyperthyroidism, diabetes mellitus. In patients with diabetes mellitus, lipid metabolism disorders develop quickly and occur in a severe form, with damage to of cardio-vascular system, xanthomatosis, the appearance of sclerotic plaques.

The reference to the high level of cholesterol in a person's blood due to the person's diet with saturated fats and cholesterol plays a certain role, but this circumstance is not decisive, and therefore reducing the amount of animal fats in the patient's diet does not lead to serious positive results.

The presence of dyslipidemia, which leads to more pronounced progression of atherosclerosis and ischemic heart disease in patients with metabolic syndrome (MS), has been demonstrated in large number research. It is believed that the pathogenesis of dyslipidemia in metabolic syndrome due to the fact that against the background of hyperinsulinemia (HI) and insulin resistance (IR), lipid metabolism in the liver is disrupted. There is an increase in the synthesis of very low density lipoproteins (VLDL) by the liver. Insulin controls the activity of blood lipoprotein lipase, which, in turn, controls the excretion (elimination) of VLDL. In insulin resistance, this enzyme becomes resistant to the action of insulin and the elimination of VLDL slows down.

Impaired lipoprotein metabolism in conditions of insulin resistance is also manifested by a decrease in the concentration of high-density lipoproteins (HDL), which carry out the reverse transport of cholesterol to the liver. These changes in the spectrum of lipoproteins directly lead to an increase in plasma atherogenicity and the progression of atherosclerosis.

It is natural for humans to consume low amounts of fat. The only fats the body needs are the essential fatty acids, linoleic and alpha-linolenic (vitamins F 1 and F 2). They belong to polyunsaturated fats, and their ratio in the human diet should be balanced.
The diet of modern man has three serious disadvantages:
- too high fat intake;
- bad high-quality composition fats;
- ratio of essential fatty acids hopelessly broken.

IN modern world It is unrealistic to completely give up fat. The most reasonable course of action is to reduce their consumption to a minimum and monitor their qualitative and quantitative composition.

In the last fifty years, the Western consumer has suffered two major disasters. The first is well known: increasing consumption of saturated fats. The two main sources of this growth are the increasing consumption of livestock meat and the increasing consumption of dairy products. Both types of products are dangerous for the human diet because they can have adverse effects on health.

Saturated fats are dangerous because they can slip through the hormonal cascade of essential fatty acids. In addition, they suppress immune system and other vital metabolic processes.

The second disaster is less well known. This a sharp increase consumption of vegetable oil, and primarily the so-called OMEGA-6 oils. This class includes sunflower, corn, peanut and safflower oils. These types of oil, which were virtually unknown before World War II, now make up a significant proportion of the ever-increasing amount of fat consumed. Plus, they're cheap and easily available! Hence their excessive consumption.

An even greater danger is that these vegetable oils completely monopolized the hormonal cascade of fatty acids. They clog the alpha-linolenic acid pathway and lead to excess production of certain hormones that are harmful to health.

In the diet ordinary person There are 30 times more oils from the OMEGA-6 group (corn, sunflower) than oils from the OMEGA-3 group (oil walnuts, flaxseed, canola-rapeseed, fatty deep-sea and sea ​​fish), which leads to the activation of the enzyme delta-6-desaturase and the production of “harmful” prostaglandins.

In turn, this leads to excess production of harmful hormones, which cause a number of different disorders:
- formation of plaques (sclerosis);
- immune suppression (cancer);
- increased blood clotting (thrombosis);
- inflammation (arthritis);
- production of histamines (allergies);
- narrowing of blood vessels (violation of cellular nutrition);
- hypertension (high blood pressure);
- autoimmune reactions (arthritis, allergies, asthma, lupus);
- excess insulin production (hyperinsulinemia);
- compression of the bronchi (asthma);
- vector suppression nerve impulses(pain).

Only one type of concentrated oil has optimal composition is canola oil, also called rapeseed oil. On sale you can find “pates” made on its basis.

Walnut oil and flaxseed oil are also suitable. Hemp oil has an excellent composition. Main advantage olive oil is that it is neither a saturated fat nor an OMEGA-6 fat. Its effect on metabolism in the body is completely neutral. The most healthy ratio of essential fatty acids OMEGA-3 and OMEGA-6 lies between 1:1 - 1:4, in this case the body synthesizes balanced prostaglandins (group 1, 2, 3).

All solid fats are suspect. Their hardness indicates the presence of large amounts of saturated fat. In addition, trans fatty acids and hydrogenated fats should be avoided. They are no less harmful than saturated fats. All of them completely disrupt the hormonal cascade. If you consume too many saturated fats, hydrogenated fats and trans fatty acids, it does not matter how many essential fatty acids are present in the diet, as their absorption will be blocked and the body will suffer from a deficiency of these substances.

Fatty acids are present in food and blood mainly in the form of triglycerides. A triglyceride is a glycerol molecule to which three fatty acids are attached. The trick is that, upon entering the body, the triglyceride is broken down in the digestive tract into its component parts, which come back together in the blood, but at the same time form another triglyceride.

And now the second trick. The digestibility of a fatty acid depends on its position in the molecule. For example, cocoa butter has less effect on blood cholesterol levels, since its saturated fatty acids occupy a spatial position that is different from other “harmful” fatty acids.

Digestive system It processes fatty acids located in this position worse, and, therefore, they are less absorbed by the body. This property of the body is enhanced by the formation of calcium salts. Apparently, this explains the relative harmlessness of the fats contained in cheese. That's why in the diet natural nutrition you can include some, at first glance, inappropriate fatty food products(such as avocado and cocoa butter).

Fat Summary:
- you need to consume as little fat as possible;
- consumed fats should be rich in essential fatty acids;
- best views vegetable oils - these are canola oil (the best and has a wide range of applications), walnut oil, hemp and flaxseed oil (they can be used, for example, for seasoning dishes);
- it is necessary to include “fatty” fish in the diet several times a week;
- It is necessary to exclude “harmful” fats from the diet.

How is fat formed in the human body?

The human body can form lipids or triglycerides not only from fats coming from food, but also from carbohydrates and proteins. Fats from incoming food enter the gastrointestinal tract, are absorbed in the small intestine, undergo a transformation process and are broken down into fatty acids and glycerol. There are also internal, endogenous fats that are synthesized in the liver. Fatty acids are a source of large amounts of energy, being a kind of body “fuel”.

They are absorbed into the blood and, with the help of special transport forms - lipoproteins, chylomicrons, are carried to various bodies and fabrics. Fatty acids can again be used for the synthesis of triglycerides and fat, and if they are in excess, they can be stored in the liver and in adipose tissue cells - adipocytes. It is adipocytes with a large supply of triglycerides that create discomfort for humans and are manifested by excess deposits of subcutaneous fat and overweight. Fat deposits can also be formed from carbohydrates.

Glucose and fructose entering the blood with the help of the hormone insulin can be deposited in the form of triglycerides in the liver and cells. Proteins supplied with food are also capable of being transformed into triglycerides through a cascade of transformations: broken down proteins into amino acids are absorbed into the blood, penetrate into the liver, are converted into glucose and, under the action of insulin, become triglycerides stored in adipocytes. So, in a very simplified way, we can imagine the process of lipid formation in human body.

2 Functions of lipids in the body

The role of fats in the human body is difficult to overestimate. They are:

• the main energy source in the body;
• building material for cell membranes, organelles, a number of hormones and enzymes;
• a protective “cushion” for internal organs.

Fat cells carry out thermoregulation, increase the body's resistance to infection, secrete hormone-like substances - cytokines, and also regulate metabolic processes.

3 How are fats used?

Triglycerides stored “in reserve” can leave adipocytes and be used for cell needs when they receive insufficient energy or require structural material to build membranes. Hormones of the body that have a lipolytic effect - adrenaline, glucagon, somatotropin, cortisol, hormones thyroid gland, send a signal to adipocytes - lipolysis or the process of fat breakdown occurs.

Having received “instructions” from hormones, triglycerides are broken down into fatty acids and glycerol. Fatty acids are transported into the blood using carriers called lipoproteins. Lipoproteins in the blood interact with cell receptors, which break down lipoproteins and take fatty acids for further oxidation and use: building membranes or producing energy. Lipolysis can be activated under stress and excessive physical activity.

4 Why is lipid metabolism disrupted?

Dyslipidemia or lipid metabolism disorder is a condition in which, due to various reasons, there is a change in the content of lipids in the blood (increase or decrease), or the appearance of pathological lipoproteins. The condition is caused by pathological processes in the synthesis, breakdown of fats or their inadequate removal from the blood. Problems in lipid metabolism can lead to excess fat in the blood - hyperlipidemia.

According to research, this condition is typical for 40% of the adult population, and occurs even in childhood.

Disorders of lipid metabolism can be provoked by a number of factors that trigger pathological processes of imbalance in the supply and utilization of lipids. Risk factors include:

• physical inactivity or a sedentary lifestyle,
• smoking,
• alcohol abuse,
• increased activity of thyroid hormones,
• excess body weight,
• diseases that provoke lipid metabolic disorders.

5 Primary disorders of lipid metabolism

All lipid metabolism disorders are classified into primary and secondary. Primary due genetic defects and are hereditary in nature. There are several forms of primary disorders in lipid metabolism, the most common being familial hypercholesterolemia. This condition is caused by a defect in the gene encoding the synthesis and function of receptors that bind to certain lipoproteins. There are several forms of pathology (homo- and heterozygous), they are united by the hereditary nature of the disease, high cholesterol levels from birth, early development of atherosclerosis and ischemic heart disease.

A doctor may suspect hereditary dyslipoproteinemia in a patient if:

• early myocardial infarction;
• significant damage to blood vessels by the atherosclerotic process at a young age;
• available data on the incidence of coronary heart disease, cardiovascular accidents from close relatives at a young age.

6 Secondary disorders of lipid metabolism

These lipid metabolism disorders develop as a consequence of many diseases, as well as as a result of the consumption of certain medicines.

Causes of high blood lipids:

• diabetes,
• obesity,
• hypothyroidism,
• reception medicines: progesterone, thiazides, estrogens, glucocorticoids,
• chronic renal failure,
• stress.

Causes, causing a decrease lipid content:

• malabsorption syndrome,
• reduced, insufficient nutrition,
• tuberculosis,
• chronic liver diseases,
• AIDS.

Dyslipidemia of secondary origin is very often observed in type 2 diabetes mellitus. It is always accompanied by atherosclerosis - changes in the walls of blood vessels with the deposition of “plaques” of excess cholesterol and other lipid fractions on them. Among patients with diabetes, the most common cause of death is coronary artery disease caused by atherosclerotic disorders.

7 Consequences of high blood lipids

Excessively “fatty” blood is enemy number 1 for the body. Excessive amounts of lipid fractions, as well as defects in their utilization, inevitably lead to the fact that “everything unnecessary” settles on vascular wall with the formation of atherosclerotic plaques. Metabolic lipid disorders lead to the development of atherosclerosis, which means that in such patients the risk of developing coronary heart disease, stroke, and heart rhythm disturbances increases many times.

8 Signs indicating lipid metabolism disorders

An experienced physician may suspect dyslipidemia in a patient upon examination. External signs indicating existing advanced violations will be:

• multiple yellowish formations- xanthomas located on the torso, abdomen, forehead skin, as well as xanthelasmas - yellow spots on the eyelids;
• Men may experience early graying of hair on the head and chest;
• matte ring around the edge of the iris.

All external signs is a relative indication of a lipid metabolism disorder, and to confirm it, a set of laboratory and instrumental studies, allowing you to confirm the doctor’s assumptions.

9 Diagnosis of lipid metabolism disorders

There is an examination program to identify dyslipidemia, which includes:

• general blood test, urine test,
• BAC: determination of total cholesterol, TG, LDL cholesterol, VLDL, HDL, ASAT, ALAT, bilirubin, protein, protein fractions, urea, alkaline phosphatase,
• determining blood glucose, and if there is a tendency to increase, performing a glucose tolerance test,
• determination of abdominal circumference, Quetelet index,
• blood pressure measurement,
• Examination of the vessels of the fundus,
• EchoCG,
• radiography of the OGK.

This general list studies, which in case of lipid metabolism disorders, at the discretion of the doctor, can be expanded and supplemented.

10 Treatment of lipid metabolism disorders

Therapy for secondary dyslipidemia is aimed, first of all, at eliminating the underlying disease that caused the disorder of lipid metabolism. Correction of glucose levels in diabetes mellitus, normalization of body weight in obesity, treatment of absorption disorders and in the gastrointestinal tract are guaranteed to improve lipid metabolism. Elimination of risk factors and a lipid-lowering diet for lipid metabolism disorders is the most important part on the path to recovery.

Patients should forget about smoking, stop drinking alcohol, active image life and fight physical inactivity. Food should be enriched with PUFAs (they contain liquid vegetable oils, fish, seafood), and the overall consumption of fats and foods containing saturated fats (butter, eggs, cream, animal fat) should be reduced. Drug therapy for lipid metabolism disorders includes taking statins, fibrates, nicotinic acid, bile acid sequestrants according to indications.

Fats, proteins and carbohydrates coming from food are processed into small components, which subsequently take part in metabolism, accumulate in the body or are used to produce energy necessary for normal life. An imbalance in the lipid transformation of fats is fraught with the development of serious complications and may be one of the causes of diseases such as atherosclerosis, diabetes mellitus, and myocardial infarction.

General characteristics of lipid metabolism

Daily requirement A person's fat content is about 70-80 grams. The body receives most of the substances through food (exogenous route), the rest is produced by the liver (endogenous route). Lipid metabolism is the process by which fats are broken down into acids necessary to generate energy or form reserves of its source for later use.

Fatty acids, also known as lipids, constantly circulate in the human body. According to their structure and principle of action, these substances are divided into several groups:

• Triacylglycerols make up the bulk of lipids in the body. They protect subcutaneous tissue and internal organs, acting as heat insulators and heat retainers. Triacylglycerols are always stored by the body in reserve, as alternative source energy, in case of lack of glycogen reserves (a form of carbohydrates obtained by processing glucose).
• Phospholipids are a large class of lipids that get their name from phosphoric acid. These substances form the basis of cell membranes and take part in the metabolic processes of the body.
• Steroids or cholesterols are an important component of cell membranes and are involved in energy, water-salt metabolism, regulate sexual functions.

The diversity and level of content of certain types of lipids in the cells of the body is regulated by lipid metabolism, which includes the following stages:

• Breakdown, digestion and absorption of substances in the digestive tract (lipolysis). These processes originate in oral cavity, where fats received from food, under the action of tongue lipase, break down into simpler compounds with the formation of fatty acids, monoacylglycerols and glycerol. In fact, the smallest droplets of fat, under the influence of special enzymes, are transformed into a thin emulsion, which is characterized by a lower density and an increased absorption area.
• Transport of fatty acids from the intestine to lymphatic system. After initial processing, all substances enter the intestine, where, under the action of bile acids and enzymes, they break down into phospholipids. New substances easily penetrate through the intestinal walls into the lymphatic system. Here they are again converted into triacylglycerols, bind to chylomicrons (molecules similar to cholesterol and better known as lipoproteins) and enter the blood. Lipoproteins interact with cell receptors, which break down these compounds and take the fatty acids necessary for energy production and membrane construction.
• Interconversion (catabolism) of fatty acids and ketone bodies. In fact, this is the final stage of lipid metabolism, during which some of the triacylglycerols are transported along with the blood to the liver, where they are converted into acetyl coenzyme A (abbreviated as acetyl CoA). If, as a result of the synthesis of fatty acids in the liver, acetyl CoA is released in excess, part of it is transformed into ketone bodies.
• Lipogenesis. If a person leads a sedentary lifestyle and receives fat in excess, some of the breakdown products of lipid metabolism are deposited in the form of adipocytes (adipose tissue). They will be used by organisms in case of energy shortage or when required additional material for the construction of new membranes.

Signs of lipid metabolism disorders

Congenital or acquired pathology of fat metabolism in medicine is called dyslipidemia(ICD code E78). Often this disease is accompanied by a number of symptoms reminiscent of atherosclerosis (a chronic disease of the arteries, characterized by a decrease in their tone and elasticity), nephrosis (damage to renal tubules), cardiovascular diseases endocrine system. With high triglyceride levels, the syndrome may occur acute pancreatitis. Characteristic clinical manifestations lipid metabolism disorders are:

• Xanthomas are dense nodular formations filled with cholesterol. Cover the tendons, abdomen, and torso of the feet.
• Xanthelasmas are cholesterol deposits under the skin of the eyelids. Fatty deposits of this type are localized in the corners of the eyes.
• The lipoid arc is a white or grayish-white stripe framing the cornea of ​​the eye. More often, the symptom appears in patients over 50 years of age with a hereditary predisposition to dyslipidemia.
• Hepatosplenomegaly is a condition of the body in which the liver and spleen simultaneously increase in size.
• Skin atheroma is a cyst of the sebaceous glands that occurs as a result of blockage of the sebaceous ducts. One of the factors in the development of pathology is a disorder of phospholipid metabolism.
• Abdominal obesity– excess accumulation of adipose tissue in the upper torso or abdomen.
• Hyperglycemia is a condition in which the level of glucose in the blood increases.
• Arterial hypertension is a persistent increase in blood pressure above 140/90 mm Hg. Art.

All of the above symptoms are characteristic of elevated lipid levels in the body. However, there are situations when the amount of fatty acids is below normal. In such cases characteristic symptoms will be:

• a sharp and causeless decrease in body weight, up to complete exhaustion (anorexia);
• hair loss, brittleness and splitting of nails;
• violation menstrual cycle(delay or complete absence of menstruation), reproductive system in women;
• signs of kidney nephrosis - darkening of urine, pain in the lower back, decreased volume of daily urine, formation of edema;
• eczema, pustules or other inflammations of the skin.

Causes

Lipid metabolism may be impaired by certain chronic diseases or be congenital. According to the mechanism of formation of the pathological process, two groups are distinguished possible reasons dyslipidemia:

• Primary - inheritance from one or both parents of a modified gene. There are two forms of genetic disorders:

1. hypercholesterolemia – a disorder of cholesterol metabolism;
2. hypertriglyceridemia – increased content of triglycerides in blood plasma taken on an empty stomach.

• Secondary – the disease develops as a complication of other pathologies. Lipid metabolism disorders can be caused by:

1. hypothyroidism – decreased function of the thyroid gland;
2. diabetes mellitus is a disease in which glucose absorption or insulin production is impaired;
3. obstructive liver diseases - diseases in which there is a violation of the outflow of bile (chronic cholelithiasis (formation of stones in gallbladder), primary biliary cirrhosis ( autoimmune disease, in which the intrahepatic bile ducts are gradually destroyed).
4. atherosclerosis;
5. obesity;
6. uncontrolled use of medications - thiazide diuretics, Cyclosporine, Amiodarone, some hormonal contraceptives;
7. chronic renal failure - a syndrome of impairment of all renal functions;
8. nephrotic syndrome is a symptom complex characterized by massive proteinuria (protein excretion along with urine), generalized edema;
9. radiation sickness is a pathology that occurs during prolonged exposure of the human body to various ionizing radiation;
10. pancreatitis - inflammation of the pancreas;
11. smoking, alcohol abuse.

Predisposing factors play an important role in the development and progression of lipid metabolism disorders. These include:

• physical inactivity (sedentary lifestyle);
• postmenopause;
• abuse of fatty, cholesterol-rich foods;
• arterial hypertension;
• male gender and age over 45 years;
• Cushing's syndrome – overeducation adrenal hormones;
• ischemic stroke history (death of a part of the brain due to circulatory problems);
• myocardial infarction (death of part of the heart muscle due to cessation of blood flow to it);
• genetic predisposition;
• pregnancy;
• diagnosed before the disease endocrine system, liver or kidneys.

Classification

Depending on the mechanism of development, there are several types of lipid imbalance:

• Primary (congenital) - means that the pathology is hereditary. Clinicians divide this type of lipid metabolism disorder into three forms:

1. monogenic – when the pathology is caused by gene mutations;
2. homozygous - rare form, means that the child received the pathological gene from both parents;
3. heterozygous - obtaining defective gene from father or mother.

• Secondary (acquired) – develops as a consequence of other diseases.

• Nutritional – related to human nutritional characteristics. There are two forms of pathology:

1. transient – ​​occurs irregularly, more often on the next day after consuming a large amount fatty foods;
2. constant – noted when regular use foods high in fat.

Fredrickson's classification of dyslipidemias is not widely used among doctors, but is used World Organization Healthcare. The main factor by which lipid metabolism disorders are divided into classes is the type of elevated lipid:

• The disease of the first type occurs due to genetic disorders. An increased content of chylomicrons is observed in the patient's blood.
• Type 2 lipid metabolism disorder is a hereditary pathology characterized by hypercholesterolemia (subtype A) or combined hyperlipidemia (subtype B).
• The third type is a pathological condition in which there is an absence of chylomicrons in the patient’s blood and the presence of low-density lipoproteins.
• The fourth type of disorder is hyperlipidemia (abnormally elevated lipid levels) of endogenous origin (produced by the liver).
• The fifth type is hypertriglyceridemia, characterized by increased content triglycerides in blood plasma.

Doctors summarized this classification, reducing it to just two points. These include:

• pure or isolated hypercholesterolemia – a condition characterized by increased cholesterol levels;
• combined or mixed hyperlipidemia is a pathology in which the level of both triglycerides and cholesterol and other components of fatty acids increases.

Possible complications

Disorders of lipid metabolism can lead to a number of unpleasant symptoms, severe weight loss, and worsening of chronic diseases. Besides, This pathology in metabolic syndrome can cause the development of the following diseases and conditions:

• atherosclerosis, which affects the blood vessels of the heart, kidneys, brain, heart;
• narrowing of the lumen of blood arteries;
• formation of blood clots and emboli;
• the occurrence of an aneurysm (vascular dissection) or rupture of arteries.

Diagnostics

To make an initial diagnosis, the doctor conducts a thorough physical examination: assesses the condition of the skin, mucous membranes of the eye, measures blood pressure, palpation abdominal cavity. Afterwards, laboratory tests are prescribed to confirm or refute suspicions, which include:

• General clinical analysis of blood and urine. Conducted to identify inflammatory diseases.
• Biochemical analysis blood. Biochemistry determines the level of blood sugar, protein, creatinine (a breakdown product of protein), uric acid (the end product of the breakdown of DNA and RNA nucleotides).
• Lipidogram - analysis of lipids, is the main method for diagnosing lipid metabolism disorders. Diagnostics shows the level of cholesterol, triglycerides in the blood and establishes the atherogenicity coefficient (the ratio of the total amount of lipids to cholesterol).
• Immunological analysis blood. Determines the presence of antibodies (special proteins that are produced by the body to fight foreign bodies) to chlamydia and cytomegalovirus. An immunological test additionally detects the level of C-reactive protein (a protein that appears during inflammation).
• Genetic blood test. The study identifies inherited genes that have been damaged. Blood for diagnostics mandatory taken from the patient himself and his parents.
• CT (computed tomography), ultrasound ( ultrasonography) abdominal organs. They identify pathologies of the liver, spleen, pancreas, and help assess the condition of the organs.
• MRI (magnetic resonance imaging), radiography. Assigned as additional instrumental methods diagnostics when there is a suspicion of problems with the brain or lungs.

Treatment of fat metabolism disorders

To eliminate the pathology, patients are prescribed a special diet with a limited intake of animal fats, but enriched dietary fiber and minerals. In people with overweight, the calorie content of the daily diet is reduced and moderate physical activity is prescribed, which is necessary to normalize body weight. All patients are advised to give up or reduce their alcohol consumption as much as possible. When treating secondary dyslipidemias, it is important to identify and begin treatment of the underlying disease.

To normalize the blood count and the patient’s condition, drug therapy. Eliminate unpleasant symptoms, the following groups of drugs help to establish lipid metabolism:

• Statins are a class of drugs that help lower blood levels. bad cholesterol, increase the possibility of lipid destruction. Medicines from this group are used for the treatment and prevention of atherosclerosis and diabetes mellitus. They significantly improve the patient’s quality of life, reduce the incidence of heart disease, and prevent vascular damage. Statins can cause liver damage and are therefore contraindicated in people with liver problems. These medications include:

1. Pravachol;
2. Zokor;
3. Crestor;
4. Lipitor;
5. Leskol.

• Cholesterol absorption inhibitors are a group of medications that prevent the reabsorption of cholesterol in the intestine. The effect of these drugs is limited, because a person receives only a fifth of bad cholesterol from food, the rest is produced in the liver. Inhibitors are prohibited for pregnant women, children, and during lactation. Popular medications in this group include:

1. Guarem;
2. Ezetimibe;
3. Lipobon;
4. Ezetrol.

• Bile acid sequestrants (ion exchange resins) are a group of medications that bind bile acids (containing cholesterol) when they enter the intestinal lumen and remove them from the body. When taken for a long time, sequestrants can cause constipation, taste disturbances, and flatulence. These include drugs with the following trade names:

1. Questran;
2. Colestipol;
3. Lipantil 200 M;
4. Tribestan.

• Antioxidant vitamins and polyunsaturated fatty acids Omega-3 – group multivitamin complexes, which reduce triglyceride levels, reduce the risk of developing cardiovascular diseases. Such additives include:

1. Vitrum Cardio Omega-3;
2. ViaVit;
3. Mirrolla capsules with Omega-3;
4. AspaCardio.

• Fibrates are a group of drugs that reduce triglycerides and increase the amount of high-density lipoproteins (protective substances that prevent the development of cardiovascular disorders) . Medicines in this category are prescribed together with statins. Fibrates are not recommended for use by children or pregnant women. These include:

1. Normolit;
2. Lipantil;
3. Lipanor;
4. Bezalip;
5. Gevilon.

Diet therapy

Lipid metabolism in the human body directly depends on what he eats. A properly formulated diet will alleviate the patient’s condition and help restore metabolic balance. Detailed menu, the list of prohibited and permitted foods is compiled by a doctor, but there are also general rules regarding nutrition:

1. Eat no more than 3 egg yolks per week (including eggs used for other food preparations).
2. Reducing consumption confectionery, bread, muffins.
3. Replacing deep frying with stewing, steaming, boiling or baking.
4. Exclusion from the diet of smoked meats, marinades, sauces (mayonnaise, ketchup), sausages.
5. Increase in soto
6. proper consumption of plant fiber (vegetables and fruits).
7. There are only lean meats. When cooking, cut off visible fat and skin, remove rendered fat when preparing dishes.

Treatment with folk remedies

Traditional medicine can be used as an auxiliary therapy: decoctions, alcohol tinctures, infusions. For lipid metabolism disorders, the following recipes have proven themselves to be effective:

1. Mix and grind 100 grams of the following herbs using a coffee grinder: chamomile, knotweed, birch buds, immortelle, St. John's wort. Measure 15 grams of the mixture, pour 500 ml of boiling water. Insist for half an hour. Take the medicine warm, adding a teaspoon of honey, 200 ml in the morning and evening. Every day you should prepare a new drink. Store the remaining mixture in a dark place. Duration of therapy is 2 weeks.
2. Measure out 30 g of fireweed tea, pour 500 ml of boiling water over the herb. Bring the mixture to a boil over low heat, then leave for 30 minutes. Take the medicine 4 times a day before meals, 70 ml. The course of treatment is 3 weeks.
3. Pour dried plantain leaves (40 grams) with a glass of boiling water. Leave for 30 minutes, then filter. Take 30 ml of the drink 3 times a day 30 minutes before meals. The course of therapy is 3 weeks.

Video

Lipid metabolism is the metabolism of fats in the human body, which is complex physiological process, as well as a chain biochemical reactions that occur in the cells of the whole body.

In order for cholesterol and triglyceride molecules to move through the bloodstream, they stick to protein molecules, which are transporters in the bloodstream.

With the help of neutral lipids, bile acids and steroid hormones are synthesized, and molecules of neutral lipids fill each cell of the membrane with energy.

By binding to low molecular density proteins, lipids are deposited on vascular membranes in the form of a lipid spot with the subsequent formation of an atherosclerotic plaque from it.

Lipoprotein composition

Lipoprotein (lipoprotein) consists of a molecule:

• Esterified form of CS;
• Non-esterified form of cholesterol;
• Triglyceride molecules;
• Protein and phospholipid molecules.

Components of proteins (proteids) in the composition of lipoprotein molecules:

• Apoliprotein (apolyprotein);
• Apoprotein (apoprotein).

The whole process fat metabolism is divided into two types of metabolic processes:

• Endogenous fat metabolism;
• Exogenous lipid metabolism.

If lipid metabolism occurs with cholesterol molecules that enter the body with food, then this is an exogenous metabolic pathway. If the source of lipids is their synthesis by liver cells, then this is an endogenous metabolic pathway.

There are several fractions of lipoproteins, of which each fraction performs certain functions:

• Chylomicron molecules (CM);
• Very low molecular density lipoproteins (VLDL);
• Low molecular density lipoproteins (LDL);
• Medium molecular density lipoproteins (MDL);
• High molecular density lipoproteins (HDL);
• Triglyceride (TG) molecules.

The metabolic process between lipoprotein fractions is interconnected.

Cholesterol and triglyceride molecules are needed:

• For the functioning of the hemostasis system;
• To form the membranes of all cells in the body;
• For the production of hormones by endocrine organs;
• For the production of bile acids.

Functions of lipoprotein molecules

The structure of the lipoprotein molecule consists of a core, which includes:

• Esterified cholesterol molecules;
• Triglyceride molecules;
• Phospholipids, which cover the core in 2 layers;
• Apoliprotein molecules.

The lipoprotein molecule differs from each other in the percentage of all components.

Lipoproteins differ depending on the presence of components in the molecule:

• To size;
• By density;
• According to its properties.

Indicators of fat metabolism and lipid fractions in the blood plasma:

Lipid metabolism disorder

Disorders in lipoprotein metabolism are a disruption in the process of synthesis and breakdown of fats in the human body. These abnormalities in lipid metabolism can occur in any person.

Most often, the cause may be a genetic predisposition of the body to the accumulation of lipids, as well as poor nutrition with a high consumption of cholesterol-containing fatty foods.

Causes of disorders in lipid metabolism

This pathology quite often develops as a consequence pathological disorders in body systems, but there is a hereditary etiology of cholesterol accumulation in the body:

• Hereditary genetic chylomicronemia;
• Congenital genetic hypercholesterolemia;
• Hereditary genetic dys-beta-lipoproteinemia;
• Combined type of hyperlipidemia;
• Endogenous hyperlipidemia;
• Hereditary genetic hypertriglycerinemia.

Also, disorders in lipid metabolism can be:

• Primary etiology which is represented by hereditary congenital hypercholesterolemia, due to a defective gene in the child. A child may receive the abnormal gene from one parent (homozygous pathology), or from both parents (heterozygous hyperlipidemia);
• Secondary etiology of disorders in fat metabolism, caused by disturbances in the functioning of the endocrine system, malfunction liver and kidney cells;
• Nutritional causes of imbalance between cholesterol fractions, derived from Not proper nutrition patients when the menu is dominated by cholesterol-containing products of animal origin.

Secondary causes of disorders in lipid metabolism

Secondary hypercholesterolemia develops due to existing pathologies in the patient’s body:

• Systemic atherosclerosis. This pathology can develop on the basis of primary hypercholesterolemia, as well as from poor nutrition, with a predominance of animal fats;
• Bad habits - nicotine and alcohol addiction. Chronic consumption affects the functionality of liver cells, which synthesize 50.0% of the total cholesterol contained in the body, and chronic nicotine addiction leads to weakening of the arterial membranes, on which cholesterol plaques can be deposited;
• Lipid metabolism is also impaired in diabetes mellitus;
• In the chronic stage of liver cell failure;
• With pathology of the pancreas - pancreatitis;
• With hyperthyroidism;
• Diseases associated with impaired functionality of endocrine organs;
• When Whipple syndrome develops in the body;
• At radiation sickness, and malignant oncological neoplasms in organs;
• Development of biliary type of cirrhosis of liver cells in stage 1;
• Deviations in the functionality of the thyroid gland;
• Pathology hypothyroidism, or hyperthyroidism;
• Application of many medications as self-medication, which leads not only to lipid metabolism disorders, but can also trigger irreparable processes in the body.

Factors that provoke disorders in lipid metabolism

Risk factors for disorders in fat metabolism include:

• Human gender. Men are more susceptible to fat metabolism disorders. Female body protected from lipid accumulation by sex hormones during reproductive age. With the onset of menopause, women are also prone to hyperlipidemia and the development of systemic atherosclerosis and pathologies of the cardiac organ;
• Patient's age. Men - after 40 - 45 years, women after 50 years of age at the time of development climacteric syndrome and menopause;
• Pregnancy in a woman, an increase in the cholesterol index is due to natural biological processes in the female body;
• Physical inactivity;
• Unhealthy diet, in which the maximum amount of cholesterol-containing foods in the menu;
• High blood pressure index - hypertension;
• Excess body weight - obesity;
• Cushing's pathology;
• Heredity.

Medications that lead to pathological changes in lipid metabolism

Many medications provoke the occurrence of the pathology dyslipidemia. The development of this pathology can be aggravated by self-medication, when the patient does not know the exact effects of medications on the body and the interaction of drugs with each other.

Improper use and dosage lead to an increase in cholesterol molecules in the blood.

Table of medications that affect the concentration of lipoproteins in the blood plasma:

When using hormone replacement therapy, the hormone estrogen and the hormone progesterone, which are part of medications, reduce HDL molecules in the blood.

Oral contraceptive medications also reduce high molecular weight cholesterol in the blood.

Signs of changes in lipid metabolism

Symptoms of the development of hypercholesterolemia of primary etiology (genetic) and secondary etiology (acquired) cause a large number of changes in the patient’s body.

Many symptoms can only be identified through diagnostic testing using instrumental and laboratory techniques, but there are also symptoms that can be detected visually and using the palpation method:

• Xanthomas form on the patient’s body;
• Formation of xanthelasmas on the eyelids and on the skin;
• Xanthomas on tendons and joints;
• The appearance of cholesterol deposits in the corners of the eye incisions;
• Body weight increases;
• There is an enlargement of the spleen, as well as the liver organ;
• Clear signs of the development of nephrosis are diagnosed;
• Generalized symptoms of endocrine system pathology are formed.

This symptomatology indicates a violation of lipid metabolism and an increase in the cholesterol index in the blood.

When there is a change in lipid metabolism towards a decrease in lipids in the blood plasma, the following symptoms are pronounced:

• Body weight and volume decrease, which can lead to complete exhaustion of the body - anorexia;
• Hair loss from the scalp;
• Separation and brittleness of nails;
• Eczema and ulcers on the skin;
• Inflammatory processes on the skin;
• Dry skin and exfoliation of the epidermis;
• Pathology nephrosis;
• Disorders of the menstrual cycle in women;
• Female infertility.

Symptoms of changes in lipid metabolism are the same in children's body and in the adult body.

Children more often show external signs of an increase in the cholesterol index in the blood, or a decrease in lipid concentrations, and in an adult body, external signs appear when the pathology progresses.

Diagnostics

to install correct diagnosis, the doctor must examine the patient and also refer the patient to laboratory diagnostics blood composition. Only in the aggregate of all the research results can we put accurate diagnosis changes in lipid metabolism.

The primary diagnostic method is carried out by the doctor at the patient’s first appointment:

• Visual examination of the patient;
• Studying the pathology of not only the patient himself, but also genetic relatives to identify familial hereditary hypercholesterolemia;
• Anamnesis collection. Special attention pays attention to the patient’s nutrition, as well as lifestyle and addictions;
• The use of palpation of the anterior wall of the peritoneum, which will help identify the pathology of hepatosplenomegaly;
• The doctor measures the blood pressure index;
• A complete survey of the patient about the onset of the development of pathology in order to be able to establish the onset of changes in lipid metabolism.

Laboratory diagnosis of disorders in lipid metabolism is carried out using the following method:

• General analysis of blood composition;
• Biochemistry of plasma blood composition;
• General urine analysis;
• Laboratory blood test with metol lipid spectrum- lipograms;
• Immunological analysis of blood composition;
• Blood to identify the index of hormones in the body;
• Study of genetic detection of defective and abnormal genes.

Methods of instrumental diagnostics for disorders of fat metabolism:

• Ultrasound (ultrasound examination) of liver and kidney cells;
• CT (computed tomography) of internal organs that are involved in lipid metabolism;
• MRI (magnetic resonance imaging) of internal organs and the blood flow system.

How to restore and improve cholesterol metabolism?

Correcting fat metabolism disorders begins with a review of lifestyle and nutrition.

The first step after making a diagnosis is to immediately:

• Give up existing bad habits;
• Increase your activity, you can start riding a bike, or go to the pool. A 20-30 minute session on an exercise bike will do, but riding a bike takes longer. fresh air, preferable;
• Constant control of body weight and the fight against obesity;
• Diet food.

A diet for liposynthesis disorders can:

• Restore lipid and carbohydrate metabolism in the patient;
• Improve the functioning of the heart organ;
• Restore blood microcirculation in the cerebral vessels;
• Normalization of metabolism of the whole body;
• Reduce bad cholesterol levels to 20.0%;
• Prevent formation cholesterol plaques in the main arteries.

Restoring lipid metabolism with nutrition

Dietary nutrition for disorders of the metabolism of lipids and lipid-like compounds in the blood is initially the prevention of the development of atherosclerosis and diseases of the heart organ.

Diet not only acts as an independent part non-drug therapy, but also as a component of the complex drug treatment drugs.

The principle of proper nutrition to normalize fat metabolism:

• Limit consumption of cholesterol-containing foods. Eliminate from the diet foods containing animal fat - red meats, fatty dairy products, eggs;
• Meals in small portions, but not less than 5 - 6 times a day;
• Introduce fiber-rich foods into your daily diet - fresh fruits and berries, fresh and boiled and stewed vegetables, as well as cereals and legumes. Fresh vegetables and fruits will fill the body with a whole complex of vitamins;
• Eat sea fish up to 4 times a week;
• Use vegetable oils that contain Omega-3 polyunsaturated fatty acids - olive, sesame and flaxseed oil - in cooking daily;
• Eat meat only low-fat varieties, and cook and eat poultry without skin;
• Fermented milk products must have 0% fat content;
• Introduce nuts and seeds into your daily menu;
• Increased drinking. Drink at least 2000.0 milliliters of clean water per day.

Correction of impaired lipid metabolism with the help of medications gives best result in normalizing the total cholesterol index in the blood, as well as restoring the balance of lipoprotein fractions.

Drugs used to restore lipoprotein metabolism:

Using folk remedies

Lipid metabolism disorders can be treated with medicinal plants and herbs only after consultation with your doctor.

Effective plants in restoring lipoprotein metabolism:

• Plantain leaves and roots;
• Immortelle flowers;
• Horsetail leaves;
• Chamomile and calendula inflorescences;
• Leaves of knotweed and St. John's wort;
• Hawthorn leaves and fruits;
• Leaves and fruits of strawberries and viburnum plants;
• Dandelion roots and leaves.

Traditional medicine recipes:

• Take 5 spoons of strawberry flowers and steam with 1000.0 milliliters of boiling water. Leave for 2 hours. Take 3 times a day, 70.0 - 100.0 milligrams. This infusion restores the functioning of liver and pancreas cells;
• Every morning and every evening, take 1 teaspoon of crushed flax seeds. You need to drink 100.0 - 150.0 milliliters of water or skim milk;
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Life forecast

The prognosis for life is individual for each patient, because the failure of lipid metabolism in each has its own etiology.

If a malfunction in metabolic processes in the body is diagnosed in a timely manner, then the prognosis is favorable.

Lipids consist of four stages: breakdown, absorption, intermediate and final metabolism.

Lipid metabolism: splitting. Most lipids that make up food are absorbed by the body only after preliminary breakdown. Under the influence of digestive juices, they are hydrolyzed (split) into simple compounds (glycerol, higher fatty acids, sterols, phosphoric acid, nitrogenous bases, higher alcohols, etc.), which are absorbed by the mucous membrane of the digestive canal.

In the oral cavity, food containing lipids is mechanically crushed, mixed, moistened with saliva and transformed into a food bolus. The crushed food masses enter the stomach through the esophagus. Here they mix and seep and contain a lipolytic enzyme - lipase, which can break down emulsified fats. From the stomach, food masses enter in small portions into duodenum, then into the jejunum and ileum. Here the process of lipid breakdown is completed and the products of their hydrolysis are absorbed. Bile, pancreatic juice and intestinal juice.

Bile is a secretion that is synthesized by hepatocytes. Includes bile acids and pigments, hemoglobin breakdown products, mucin, cholesterol, lecithin, fats, some enzymes, hormones, etc. Bile takes part in the emulsification of lipids, their breakdown and absorption; promotes normal intestinal motility; shows bactericidal effect on intestinal microflora. synthesized from cholesterol. Fatty acids reduce the surface tension of fat droplets, emulsifying them, stimulate the secretion of pancreatic juice, and also activate the action of many enzymes. IN thin section intestines, food masses leak through pancreatic juice, which includes sodium bicarbonate and lipolytic enzymes: lipases, cholinesterases, phospholipases, phosphatases, etc.

Lipid metabolism: absorption. Most of the lipids are absorbed in the lower part of the duodenum and in the upper part. Products of the breakdown of food lipids are absorbed by the villous epithelium. The suction surface is increased due to microvilli. The end products of lipid hydrolysis consist of fine particles fat, di- and monoglycerides, higher fatty acids, glycerol, glycerophosphates, nitrogenous bases, cholesterol, higher alcohols and phosphoric acid. There are no lipolytic enzymes in the large intestine. Colon mucus contains small amounts of phospholipids. Cholesterol that is not absorbed is reduced to fecal coprosterol.

Lipid metabolism: intermediate metabolism. For lipids, it has some features, which consist in the fact that in the small intestine, immediately after the absorption of digestion products, resynthesis of lipids inherent in humans occurs.

Lipid metabolism: terminal metabolism. The main end products of lipid metabolism are carbon dioxide and water. The latter is excreted in urine and sweat, partly in feces, and exhaled air. Carbon dioxide secreted mainly by the lungs. The final metabolism for individual groups of lipids has its own characteristics.

Lipid metabolism disorders. Lipid metabolism is disrupted in many infectious, invasive and non-communicable diseases. The pathology of lipid metabolism is observed when the processes of breakdown, absorption, biosynthesis and lipolysis are disrupted. Among lipid metabolism disorders, obesity is the most frequently recorded.

Obesity is the body's predisposition to excessive weight gain due to excess fat deposition in the subcutaneous tissue and other body tissues and intercellular space. Fats are stored inside fat cells in the form of triglycerides. The number of lipocytes does not increase, but only their volume increases. It is this hypertrophy of lipocytes that is the main factor in obesity.