Diabetes and dyslipidemia

• Dyslipidemia is important due to its causal relation with atherosclerosis and cardiovascular disease; • Plasma lipid concentrations are stratified according to the presence of different cardiovascular risk factors in an individual and may differ between different subjects; • The traditional classification of hyperlipidemia is based on the pattern of plasma lipoprotein elevation as observed in lipoprotein electrophoresis. However, most current clinical guidelines on hyperlipidemia management are not based on electrophoresis results; • Hyperlipidemia may be divided into primary and secondary disorders. In the first case, genetic defects alter normal metabolism of lipoproteins. Other factors that modify lipoprotein metabolism, such as diabetes mellitus, increase lipoprotein concentrations in secondary hyperlipidemia. Many patients suffer both primary genetic disorders and secondary causes: the primary genetic defect predisposes them to a more severe expression of the secondary lipid disorder associated with underlying pathologies such as obesity and diabetes; • Elevated plasma lipids (cholesterol or triglycerides) can accumulate in macrophage reticuloendothelial cells in certain tissues. The clinical expression may be as Xanthelasmas, Tendon, Tuberous, Palmar, and Eruptive Xanthomas; • Serum triglyceride concentrations exceeding 1000 mg/dL (11 mmol/L) may precipitate attacks of acute pancreatitis. The pathogenesis of hypertriglyceridemic pancreatitis is unclear, but the release of free fatty acids may damage pancreatic acinar cells or capillary endothelium;