Abstract
A 59-yr-old man presented with the diagnosis of type 2 diabetes. He was in good health until 5 yr ago when he presented to the emergency room (ER) with an episode of chest pain and numbness in his jaw that occurred as he was walking up stairs. He was admitted to the hospital, and although an acute myocardial infarction (MI) was ruled out, an exercise stress test was positive. Coronary angiography revealed triple-vessel disease, and a coronary bypass operation was performed. Risk factors for coronary disease included the following: family history—his father died of an MI at age 52, mild hypertension —145/88, cigarette smoking-1 pack per day × 20 yr. He works as a bus driver and is 5 ft 9 in and 180 lbs. A lipid profile taken 2 mo postoperatively was as follows: cholesterol 250 mg/dL, triglyceride 180 mg/dL, HDL 30 mg/dL, and LDL 184 mg/dL. Liver, renal, and thyroid functions were normal.
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References
Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA 1990; 263: 2893–2898.
Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000; 342: 905–912.
Kasiske BL, Ma JZ, Kalil RS, Louis TA. Effects of antihypertensive therapy on serum lipids. Ann Intern Med 1995; 122: 133–141.
Lamarche B, Tchernof A, Mauriege P, Cantin B, Dangenais GR, Lupien PJ, Despres JP. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA 1998; 279: 1955–1961.
Grundy S. Small LDL, atherogenic dyslipidemia, and the metabolic syndrome. Diabetologia 1997; 40: 512–520.
Stampfer MJ, Krauss RM, Ma J, Blanche PJ, Holl LG, Sacks FM, Hennekens CH. A prospective study of triglyceride level, low-density lipoprotein particle diameter, and risk of myocardial infarction. JAMA 1996; 276: 882–888.
Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Aimeras N, Bergeron J, Gaudet D, Tremblay G, Prud’homme D, Nadeau A, Despres J-P. Hypertriglyceriemic Waist: A Marker of the Atherogenic Metabolic Triad (Hyperinsulinemia; Hyperapolipoprotein B; Small, Dense LDL) in Men? Circulation 2000; 102: 179–184.
Wilson DE, Hata A, Kwong LK, Lingam A, Shuhua J, Ridinger DN, Yeager C, Kaltenborn KC, Iverius PH, Lalouel JM. Mutations in exon 3 of th elipoprotein lipase gene segregating in a family with hypertriglyceridemia, pancreatitis, and non-insulin-dependent diabetes. J Clin Invest 1993; 92: 203–211.
Miller M. Current perspectives on the management of hypertriglyceridemia. Am Heart J 2000; 140: 232–240.
Tall AR, Jiang X, Luo Y, Silver D. 1999 George Lyman Duff memorial lecture: lipid transfer proteins, HDL Metabolism, and atherogenesis. Arterioscler Thromb Vasc Biol 2000; 20: 1185–1188.
Rubins HB, Robins SJ, Collins D, Fye CL, Anderson JW, Elam MB, Faas FH, Linares E, Schaefer EJ, Schectman G, Wilt TJ, Wittes J. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med 1999; 341: 410–418.
Wetterau JR, Aggerbeck LP, Bouma ME, Eisenberg C, Munck A, Hermier M, Schmitz J, Gay G, Rader DJ, Gregg RE. Absence of microsomal triglyceride transfer protein in individuals with abetalipo-proteinernia. Science 1992; 258: 999–1001.
Rader DJ, Brewer HB Jr. Abetalipoproteinemia. New insights into lipoprotein assembly and vitamin E metabolism for a rare genetic disease [clinical conference]. JAMA 1993; 270: 865–869.
Ginsberg H, Goldberg IJ, Wang-Iverson P, Gitler E, Le NA, Gilbert HS, Brown WV. Increased catabolism of native and cyclohexanedione-modified low density lipoprotein in subjects with myeloproliferative diseases. Arteriosclerosis 1983; 3: 223–241.
Gilbert HS, Ginsberg H. Hypocholesterolemia as a manifestation of disease activity in chronic myelocytic leukemia. Cancer 1983; 51: 1428–1433.
Pitt B, Waters D, Brown WV, van Boven AJ, Schwartz L, Title LM, Eisenberg D, Shurzinske L, McCormick LS. Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease. Atorvastatin versus Revascularization Treatment Investigators. N Engl J Med 1999; 341: 70–76.
Goldstein JL, Brown MS. The LDL receptor defect in familial hypercholesterolemia. Implications for pathogenesis and therapy. Med Clin N Amer 1982; 66: 335–362.
Illingworth DR, Stein EA, Mitchel YB, Dujovne CA, Frost PH, Knopp RH, Tun P, Zupkis RV, Greguski RA. Comparative effects of lovastatin and niacin in primary hypercholesterolemia. A prospective trial. Arch Intern Med 1994; 154: 1586–1595.
Matthews KA, Meilahn E, Kuller LH, Kelsey SF, Caggiula AW, Wing RR. Menopause and risk factors for coronary heart disease. N Engl J Med 1989; 321: 641–646.
Danese MD, Ladenson PW, Meinert CL, Powe NR. Clinical review 115: effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab 2000; 85: 2993–3001.
Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and estrogen/progestin replacement study (HERS) research group. JAMA 1998; 280: 605–613.
Franceschini G, Sirtori CR, Capurso AD, Weisgraber KH, Mahley RW. A-IMilano apoprotein. Decreased high density lipoprotein cholesterol levels with significant lipoprotein modifications and without clinical atherosclerosis in an Italian family. J Clin Invest 1980; 66: 892–900.
Zhong S, Sharp DS, Grove JS, Bruce C, Yano K, Curb JD, Tall AR. Increased coronary heart disease in Japanese-American men with mutation in the cholesteryl ester transfer protein gene despite increased HDL levels. J Clin Invest 1996; 97: 2917–2923.
Nordestgaard BG, Abildgaard S, Wittrup HH, Steffensen R, Jensen G, Tybjaerg-Hansen A. Heterozygous lipoprotein lipase deficiency: frequency in the general population, effect on plasma lipid levels, and risk of ischemic heart disease. Circulation 1997; 96: 1737–1744.
Hobbs HH, Rader DJ. ABC1: connecting yellow tonsils, neuropathy, and very low HDL. J Clin Invest 1999; 104: 1015–1017.
Brooks-Wilson A, Marcil M, Clee SM, et al. Mutations in ABC1 in Tangier disease and familial high-density lipoprotein deficiency [see comments]. Nat Genet 1999; 22: 336–345.
Cohen JC, Wang Z, Grundy SM, Stoesz MR, Guerra R. Variation at the hepatic lipase and apolipoprotein AI/CIII/AIV loci is a major cause of genetically determined variation in plasma HDL cholesterol levels. J Clin Invest 1994; 94: 2377–2384.
O’Rourke RA, Brundage BH, Froelicher VF, Greenland P, Grundy SM, Hachamovitch R, Pohost GM, Shaw LJ, Weintraub WS, Winters WL Jr, Forrester JS, Douglas PS, Faxon DP, Fisher JD, Gregoratos G, Hochman JS, Hutter AM Jr, Kaul S, Wolk MJ. American College of Cardiology/American Heart Association Expert Consensus document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease. Circulation 2000; 102: 126–140.
Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, Langendorfer A, Stein EA, Kruyer W, Gotto AM Jr. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA 1998; 279: 1615–1622.
Stone NJ. Lipid management: current diet and drug treatment options. Am J Med 1996; 101: 40S - 48S.
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Goldberg, I.J., Bukberg, P. (2002). Disorders of Lipoprotein Metabolism. In: Molitch, M.E. (eds) Challenging Cases in Endocrinology. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-277-7_19
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DOI: https://doi.org/10.1007/978-1-59259-277-7_19
Publisher Name: Humana Press, Totowa, NJ
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