OVERVIEW
Hyperlipoproteinemia type V is also known as fat- and sugar-induced hyperlipidemia, hyperchymotrypsia and hyperpre-beta-lipoproteinemia, endogenous and exogenous hyperlipidemia, and calorie-induced hyperlipidemia. Hyperlipoproteinemia due to increased celiac disease and VLDLS is a combination of hyperlipoproteinemia types I and IV. The incidence is low and most often develops in adults. It is considered a subtype of type IV and is often associated with obesity and/or alcoholism. The transformation to type IV occurs in the presence of a decreased supply of exogenous triglycerides.
Etiology
Hyperlipoproteinemia due to increased celiac disease and VLDLS is a combination of hyperlipoproteinemia types I and IV. There is increased endogenous triglyceride synthesis in the liver, as well as exogenous celiac disease, and decreased lipoproteinase levels in some patients.
Symptoms
Skin manifests as a rash of xanthomas, the incidence of atherosclerosis is unknown, and there may be hepatosplenomegaly, colic, hyperuricemia, and hyperglycemia. Triglycerides above 1000 mg/dl can cause acute pancreatitis.
Examination
1. Items of lipid examination
Increased serum TC, serum HDL-C, serum TG serum LDL-C.
2. Review
If abnormalities are found in the first test, it is advisable to review the lipid levels after 12-14 hours of fasting. serum cholesterol levels can vary by 10% within 1-2 weeks, and laboratory variation is allowed to be within 3%. at least 2 blood specimens should be examined before determining the presence of hyperlipidemia or deciding on preventive and curative measures.
Diagnosis
Serum is cloudy or milky, triglycerides are consistently elevated above 1000 mg/dl, total cholesterol levels are always elevated but LDL cholesterol is usually decreased. vLDLS and celiac disease are elevated. Glucose tolerance test and uric acid level should be done. Diagnosis can be made on the basis of clinical presentation, lesion characteristics, and characteristic serologic tests.
Treatment
Secondary factors of hypertriglyceridemia, such as diabetes mellitus or hypothyroidism, should be screened for and treated if present.
The decisive factor is weight loss to the normal range through strict control of caloric intake and alcohol abuse.
Drugs: the main applications are beta drugs and niacin derivatives.
Prognosis.
Dietary control, rapid resolution of eruptive xanthomas, coronary sclerotic heart disease, recurrent pancreatitis in untreated patients.