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10. TYPICAL DERANGEMENTS OF LIPID METABOLISM. ATHEROSCLEROSIS

Questions to prepare for classes and examination

 Typical forms of disorders of lipid metabolism.

 The main classes of lipoproteins and their functions. Atherogenic and antiatherogenic lipoproteins.

 Characteristics of hyperlipidemia. Classification of hyperlipoproteinemias according to Fredrickson.

 Mechanisms of hyperlipidemia.

 Characteristics and mechanisms of hypolipidemia.

 Obesity: definition, diagnostic approaches, pathological significance. Types and pathogenesis of obesity.

 Features and mechanisms of lypodystrophy.

 Characteristics of lipidoses.

 Atherosclerosis: description and pathological features.

 Stages of atherogenesis:

- initiation;

- formation and evolution of atheroma;

- complications.

 Risk factors of atherosclerosis.

N 53

A 15-year-old boy visited a doctor with complaints of recurrent pain in the region of the heart. The pain was exacerbated at exertion. Examination of the patient showed the presence of small, firm, yellow nodules (xanthomas) over the course of the hand muscles tendons, the presence of corneal lipid arcus. Angiographic examination revealed the coronary artery stenosis. Blood tests results demonstrate: total plasma cholesterol 22 mmol/L (normal values: 3.1-6.4 mmol/L), triglycerides 1.7 mmol/L (normal values: 0.55- 1.65 mmol/L), HDL-cholesterol 0.7 mmol/L (normal values: > 0.9 mmol/L), LDL-cholesterol 9 mmol/L (normal values: 3.0-4.5 mmol/L). The patient's

parents also have increased plasma levels of cholesterol - more than 8 mmol/L. Immunocytochemical analysis of the patient's leukocytes revealed abnormality of the LDL-receptor.

Questions

 What type of hyperlipidemia is observed in the patient?

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