### 날짜 : 2024-03-21 16:12 ### 주제 : Secondary hyperlipidemia #medicine #공부 ---- Secondary hyperlipidemia refers to elevated levels of lipids in the blood (such as cholesterol and triglycerides) that result from underlying medical conditions, lifestyle factors, or the use of certain medications. Unlike primary hyperlipidemia, which is due to genetic causes, secondary hyperlipidemia is preventable and treatable by addressing the root cause. Understanding the various factors that can lead to secondary hyperlipidemia is crucial for effective management and prevention of cardiovascular diseases. ### Causes of Secondary Hyperlipidemia: 1. **Endocrine Disorders**: - **Hypothyroidism**: Low levels of thyroid hormone can decrease the metabolism of lipids, leading to elevated cholesterol levels. - **Diabetes Mellitus**: Poorly controlled diabetes often results in high triglycerides and low HDL cholesterol levels. - **Cushing's Syndrome**: Increased cortisol levels can elevate LDL cholesterol and triglycerides. 2. **Kidney Diseases**: - **Chronic Kidney Disease (CKD)** and **[[Nephrotic Syndrome]]**: These conditions can alter lipid metabolism, leading to increased cholesterol and triglyceride levels. 3. **Liver Diseases**: - Conditions such as **non-alcoholic fatty liver disease (NAFLD)** and **cirrhosis** can disrupt normal lipid metabolism. 4. **Lifestyle Factors**: - **Obesity**: Excess body fat, particularly abdominal fat, is associated with increased triglycerides and decreased HDL cholesterol. - **Diet**: A diet high in saturated fats, trans fats, and simple sugars can elevate cholesterol and triglyceride levels. - **Alcohol**: Excessive alcohol intake can lead to elevated triglyceride levels. 5. **Medications**: - As previously discussed, certain medications like corticosteroids, beta-blockers, and others can contribute to secondary hyperlipidemia. 6. **Other Factors**: - **Smoking**: Smoking can lower HDL cholesterol and worsen the lipid profile. - **Sedentary Lifestyle**: Lack of physical activity can contribute to obesity and poor lipid profiles. ### Management and Treatment: The management of secondary hyperlipidemia involves addressing the underlying cause(s) and may include: - **Medical Management**: Treating underlying medical conditions, such as optimizing thyroid hormone levels in hypothyroidism or achieving better glycemic control in diabetes, can improve lipid levels. - **Lifestyle Modifications**: Dietary changes, regular physical activity, weight loss, limiting alcohol intake, and smoking cessation are foundational steps in managing secondary hyperlipidemia. - **Medication Adjustments**: Reviewing and possibly adjusting medications that may contribute to lipid abnormalities. - **Pharmacotherapy**: In addition to addressing the root cause, lipid-lowering medications such as statins, fibrates, or omega-3 fatty acids may be needed to manage lipid levels effectively. The approach to managing secondary hyperlipidemia is multidisciplinary, often requiring collaboration among healthcare professionals to optimize treatment strategies, reduce cardiovascular risk, and improve overall patient outcomes.