Hyperlipoproteinemia type IV
Introduction
Introduction to type IV hyperlipoproteinemia Hyperlipoproteinemia type IV, also known as fat and carbohydrate-induced hyperlipidemia, high chylomicronemia and high pre-beta-lipoproteinemia, endogenous hyperlipidemia, endogenous high Triglycerideemia, a high beta-lipoproteinemia often caused by sugars. It is the most common type, adult onset, and is autosomal recessive, but exogenous factors play an important role. May be like diabetes, is a constitutional disease. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: hyperuricemia diabetes
Cause
Hyperlipoproteinemia type IV etiology
Cause:
Mainly manifested as rash yellow tumor, sudden on the trunk, buttocks, arm extension or thigh. Severe cases can occur in any part of the skin, nodular xanthomas, jaundice and macular tumors are not typical. 40% of cases have hyperuricemia and 90% have recessive diabetes.
Prevention
Hyperlipoproteinemia type IV prevention
1. Adjust a reasonable diet to reduce the intake of saturated fatty acids and cholesterol.
2. Adjust the way of life and work: Actively participate in sports activities, avoid sedentary, and control weight. Smoking cessation is limited to alcohol.
3. Patients with a family history of coronary heart disease, diabetes, and primary hyperlipidemia should be regularly examined for blood lipids, blood sugar, and liver function.
4. Men over 40 years of age, menopausal women should be regularly checked for blood lipids every year.
5. In order to be able to detect hyperlipidemia in an early and timely manner, it is recommended that all adults over the age of 20 should regularly check plasma total cholesterol levels. Plasma triglyceride levels should be measured in all patients with pancreatitis.
Complication
Hyperlipoproteinemia type IV complications Complications, hyperuricemia, diabetes
40% of cases have hyperuricemia and 90% have recessive diabetes.
Uric acid is the terminal metabolite of human bismuth compounds. Metabolic disorders lead to hyperuricemia. In the normal sputum diet, two fasting blood uric acid levels in the same day were higher than 420mmol/L in men and higher than 360mmol/L in women, which is called hyperuricemia.
Recessive diabetes does not necessarily have obvious symptoms of diabetes, but the effect on the body is the same as true diabetes. Recessive diabetes does not allow diabetics to judge their condition from a simple three-to-one, so recessive diabetes is more dangerous. Some people have hidden symptoms because of myocardial infarction, stroke, etc., and they are known to be diabetic.
Symptom
Hyperlipoproteinemia type IV symptoms common symptoms hyperuricemia with hypertension and hyperlipidemia
Mainly manifested as rash xanthomas, sudden on the trunk, buttocks, arms stretched or thighs, severe cases can occur in any part of the skin nodular xanthomas, jaundice and macular tumors are not typical, 40% of cases Hyperuricemia, 90% of patients with recessive diabetes, serum turbidity or milk-like, triglyceride, VLDLS and apo-CIII levels increased, triglyceride concentration of 40g / L, resulting in serum turbidity, higher When the serum is milky.
Examine
Hyperlipoproteinemia type IV examination
1. Items for blood lipid examination: serum TC, serum HDL-C, serum TG serum LDL-C increased [calculated by Friedewald formula: LDL-C (mmol/L) = TC-HDL-C-TG/2.2 or LDL-C (mg/dl)=TC-HDL-C-TG/5 but limited to TGL, TG>4.5mmol/L requires direct detection.
2. If the abnormality is found in the first test, the blood lipid level after fasting for 12 to 14 hours should be reviewed. The serum cholesterol level may be 10% within 1 to 2 weeks. The laboratory variation is allowed to be within 3%. There should be at least 2 records of blood specimen examination before hyperlipidemia or decision-making measures.
Diagnosis
Differential diagnosis of type IV hyperlipoproteinemia
It should be differentiated from hyperlipoproteinemia type III and type II. Hyperlipoproteinemia type IIa, serum is transparent, cholesterol and -lipoprotein are significantly increased, apo- and LDL cholesterol are elevated, and triglycerides are normal. Hyperlipoproteinemia type IIb, serum is clear or turbid, cholesterol, triglyceride, LDL and pre-beta-lipoprotein (VLDLS) are elevated. Apo-B and apo-CIII were elevated and were identified by hyperlipoproteinemia type III only by serum electrophoresis analysis and ultracentrifugation.
