Overview of lipid metabolism and of the management of hypercholesterolemia Generalidades del metabolismo de los lípidos y del manejo de la de los lípidos y del manejo de la hipercolesterolemia

Abstract

Introduction: lipids are an important part of human biology and are precursors for the synthesis of steroid hormones and eicosanoid derivatives. Lipid requirements are satisfied through an endogenous pathway which consists of intracellular synthesis of lipids, and the intake and absorption of fats from food which constitutes the exogenous pathway. Being aware of these pathways is important for it is the starting point for achieving an adequate and timely therapeutic approach, but despite the availability of laboratory methodologies for their quantification and diagnosis, familial hypercholesterolemia (FH) remains underdiagnosed. Discussion: clinicians need to be aware of this important disorder for it is a major cause of premature cardiovascular events. Heterozygous FH has a prevalence of approximately 1/500 persons. Most FHs are secondary to impaired LDL receptor function, resulting from the presence of multiple mutations. which affects cholesterol processing. Conclusion: clinical manifestations are associated with increased LDL levels (greater than 190 mg/dL) and total cholesterol levels greater than 300 mg/dL present from birth. Statins are the first line drugs, but may not be sufficient. requiring add on therapies such as ezetimibe, bile acid sequestrants and PCSK9 inhibitors.