What is Type IV Hyperlipoproteinemia?
Type IV hyperlipoproteinemia is the most frequent (about 70% of all cases of hyperlipidemia) and is associated with impaired metabolism of endogenous triglycerides.
Causes of Type IV Hyperlipoproteinemia
The type of inheritance is not specified.
Symptoms of Type IV Hyperlipoproteinemia
Type IV hyperlipoproteinemia is found only in middle age. Increases after taking carbohydrates and alcohol. In the family are frequent indications of diabetes.
Clinical signs appear at any age, but more often in adolescence and adulthood. Characterized by an enlarged liver of a densely elastic consistency with a blunt edge (the result of fatty infiltration of the liver). Reduced carbohydrate tolerance is often observed. Many patients develop atherosclerosis of the coronary vessels, manifested by coronary heart disease. A number of patients have obesity.
Diagnosis of Type IV Hyperlipoproteinemia
Characterized by an increase in plasma levels of very low density lipoproteins (pre-beta lipoproteins) with normal or reduced levels of low density lipoproteins and the absence of chylomicrons. The amount of triglycerides in the blood serum is increased with unchanged cholesterol content. Coefficient of cholesterol: triglycerides less than 1.0. The blood plasma in the test tube is transparent or turbid, the cream-like layer does not form when standing in the refrigerator.
In the study of the fundus can be detected fat deposits in the retina. In the case of a sharp increase in triglycerides in the blood lipids can be deposited in the skin in the form of eruptive xantom.
Treatment of Type IV Hyperlipoproteinemia
Treatment is reduced to the pathogenetic correction of metabolic and clinical syndromes.
For patients with primary and secondary hyperlipoproteinemia and normal body weight, 4-fold food intake is recommended, for obesity 5-6-fold, because rare meals contribute to an increase in body weight, a decrease in glucose tolerance, the occurrence of hypercholesterolemia and hypertriglyceridemia. The main caloric intake should be in the first half of the day. for example, with 5 meals a day, the 1st breakfast should be 25% of the daily calories, the 2nd breakfast, lunch, afternoon snack and dinner, respectively, 15, 35, 10 and 15%. General strengthening therapy is also carried out, with obesity sufficient physical activity is necessary.
In type I hyperlipoproteinemia, heparin and other hypolipidemic agents have no effect. In pediatric practice, it is preferable to use drugs of a milder action: cholestyramine, clofibrate, etc. In some cases, anorectic drugs are prescribed for easier adaptation of the patient to the diet for a short time.
Effective treatments for alipoproteinemia and hypolipoproteinemia have not been developed.