50대 중반 여자 19년 9월 진료시 눈에 xanthelasma 의심 "고지혈이 높았다." 20년 11월 검진 및 혈액검사 시행 갑상선 기능은 정상이었으며 전체콜레스테롤 291, 고밀도 콜레스테롤 177.8, 중성지방 32, 저밀도콜레스테롤 106 ; 전체콜레스테롤도 높지만 고밀도가 무려 177 ! 진료실 혈압 164/78 1주일뒤 추적 혈압 152/76 확인 후 혈압 투약 시작 ARB 한가지 약제로 120~130 혈압 유지하는 분으로 매주 3~4회, 맥주 2~3병 정도의 음주량 고지혈 추적 음주량 줄인지 얼마 되지 않았다. 매번 맥주 1병 정도... 전체콜레스테롤 248, 고밀도 콜레스테롤 122,5, 중성지방 72, 저밀도콜레스테롤 111.1 apoB/A 0.34 아포리포단백 A의 수치가 매우 높다.
D2630023 Apolipoprotein AⅠ 252 H F : 108-225 mg/dL-
D2630033 Apolipoprotein B 87 F : 60-117 mg/dL-
고밀도콜레스테롤 124.7, 매일 소주 2병 음주 https://blog.naver.com/ejercicio/221997022182
HDL이 심혈관 질환의 예방적 요소로 설명이 많이 되지만 너무 높은 경우에서는 심혈관 위험이 증가한다고 보고되고 있다.
For example, research found that HDL levels above approximately 60 mg/dL showed no further improvement in prognosis, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk and IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering) studies showed that very high levels of HDL may actually be associated with an increased risk of atherosclerotic disease.
Generally, patients are asymptomatic and no medical therapy is required.
일반적으로 증상이 없으며, 치료는 필요없다.
Elevated HDL cholesterol levels usually correlate with decreased cardiovascular risk; however, high HDL cholesterol levels caused by some genetic disorders may not protect against cardiovascular disease, probably because of accompanying lipid and metabolic abnormalities.
Primary causes of elevated HDL levels are
Single or multiple genetic mutations that result in overproduction or decreased clearance of HDL.
Secondary causes of high HDL cholesterol include all of the following:
Chronic alcoholism without cirrhosis ???
Drugs (eg, corticosteroids, insulin, phenytoin, estrogen)
The unexpected finding of high HDL cholesterol in patients not taking lipid-lowering drugs should prompt a diagnostic evaluation for a secondary cause with measurements of AST (aspartate aminotransferase), ALT (alanine aminotransferase), and thyroid-stimulating hormone; a negative evaluation suggests a possible primary cause.
Cholesteryl ester transfer protein (CETP) deficiency is a rare autosomal recessive disorder caused by a CETP gene mutation. CETP facilitates transfer of cholesterol esters from HDL to other lipoproteins, and CETP deficiency affects low-density lipoprotein (LDL) cholesterol and slows HDL clearance. Affected patients display no symptoms or signs but have HDL cholesterol > 150 mg/dL (> 3.9 mmol/L). Protection from cardiovascular disorders has not been proved. No treatment is necessary.
Familial hyperalphalipoproteinemia is an autosomal dominant condition caused by various unidentified and known genetic mutations, including those that cause apoprotein A-I overproduction and apoprotein C-III variants. The disorder is usually diagnosed incidentally when plasma HDL cholesterol levels are > 80 mg/dL (> 2.1 mmol/L). Affected patients have no other symptoms or signs. No treatment is necessary.
동대문구 답십리 우리안애, 우리안愛 내과, 건강검진 클리닉 내과 전문의 전병연
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