There are many medical conditions that cause dyslipidemia. These patients do not have a disorder of lipid metabolism itself but have an underlying medical condition that causes increased cholesterol. This presentation will briefly introduce some secondary causes of dyslipidemia.
- Type 2 diabetes mellitus: The insulin resistance present in type 2 diabetes mellitus patients is associated with high levels of triglycerides (hypertriglyceridemia) and low levels of HDL. The degree of elevation in triglyceride concentration depends on the extent of insulin resistance in the patient. Hypertriglyceridemia results from an increased amount of glucose and fatty acids available in the diabetic patient.
- Nephrotic syndrome: Nephrotic syndrome refers to a group of kidney diseases that all share the pathology of abnormal filtration of blood by the kidney. The abnormalities in filtration result in a large amount of protein in the urine (proteinuria; urine protein >3.5 g/day), resulting in low serum albumin (hypoalbuminemia; serum protein <3.5 g/dL). The low serum albumin results in edema. Cholesterol abnormalities result as the liver attempts to compensate for a low serum albumin level by increasing the production of proteins, including lipoproteins.
- Hypothyroidism: This is a common cause of hyperlipidemia. In general, the worse the hypothyroidism is, the greater the dyslipidemia. The dyslipidemias associated with hypothyroidism correct after the patient receives thyroid hormone replacement.
- Alcoholism: Excessive amounts of alcohol consumption leads to hypertriglyceridemia. This is not seen with only moderate alcohol consumption.