WHAT IS DYSLIPIDEMIA?

Dyslipidemia is all about having abnormal levels of fats/lipids in blood. When triglyceride, cholesterols are absorbed in the body after digestion of food, they are carried by some proteins; this protein along with fat is known as lipoproteins. Dyslipidemia usually happens with raised triglycerides and low-density lipoprotein (LDL-C) along with reduced amounts of good fat, i.e., high-density-lipoprotein (HDL). It poses a risk by creating atherosclerosis in arteries (fat deposition, clotting, calcium deposition, inflammation and finally narrowing); this causes Atherosclerotic Cardiovascular Disease (ASCVD) including coronary artery disease (CAD), cerebrovascular disease, and peripheral artery disease (PAD).

How Common Is This?

"In India approximately 25-30% of urban and 15-20% rural subjects suffer from dyslipidemia. Although, it is more common among males, it affects both genders. The 30 to 40 years age group has a tendency to high prevalence, but for those above 60 years, it becomes markedly high.¹"

"Dyslipidemia is the most important atherosclerotic risk factor. Review of population-based studies in India shows increasing mean total cholesterol levels. Recent studies have reported that high cholesterol is present in 25-30% of urban and 15-20% rural subjects. This prevalence is lower than high-income countries. The most common dyslipidemia in India is borderline high LDL cholesterol, low HDL cholesterol and high triglycerides.²"

How Risky Is This?

"Case-control studies have reported that there is significant association of coronary events with raised apolipoprotein B, total cholesterol, LDL cholesterol and non-HDL cholesterol and inverse association with high apolipoprotein A and HDL cholesterol. Prevalence of suspected familial hypercholesterolemia in urban subjects varies from 1:125 to 1:450. Only limited studies exist regarding lipid abnormalities in children. There is low awareness, treatment and control of hypercholesterolemia in India.³"

Useful Nutraceutical Supplementation

"The combination of a lipid-lowering diet and selected scientifically proven nutraceutical supplements have the ability to reduce LDL cholesterol by up to 50%, increased LDL particle size, decreased LDL particle number, lower TG and VLDL, and increased total and type 2b HDL. In addition, inflammation, oxidative stress, immune responses, vascular target organ damage, atherosclerosis, and CVD are reduced.³"

"Subjects who received turmeric and curcumin experienced a natural cardioprotective effect, with lowering of serum LDL-C and TG levels, as compared to subjects who did not. The efficacy of turmeric and curcumin on serum TC levels remains inconclusive, despite their superior efficacy observed in patients with MetS (metabolic syndrome). A greater effect of turmeric extract in reducing serum TC levels may be observed in patients who are at risk of CVD; however, this finding needs to be confirmed in future studies. No significant change in serum HDL levels was observed. Because curcumin’s poor bioavailability limits its absorption from dietary sources, novel formulations with enhanced bioavailability are probably required to control dyslipidemia more effectively.⁴"

"The clinical efficacy of the native curcumin is weak due to its low bioavailability and high metabolism in gastrointestinal tract. During last decade, researchers have come up with different formulations with a focus on improving the bioavailability of curcumin. As a result, a significant number of bioavailable curcumin-based formulations were introduced with the varying range of enhanced bioavailability. Based on a review of these studies, it is evident that better bioavailability of formulated curcumin products is mostly attributed to improved solubility, stability and possibly low first-pass metabolism.⁵"

"This meta-analysis demonstrated the promising effects of CoQ10 supplementation on lowering lipid levels among patients with CAD, though it did not affect triglycerides, LDL-cholesterol and Lp(a) levels.⁶"

References:

1Dr. Mahtab Alam Khan, Dyslipidemia, Apr 2019, National Health Portal, India

2Gupta R, Rao RS, Misra A, Sharma SK. Recent trends in epidemiology of dyslipidemias in India. Indian Heart J. 2017 May-Jun;69(3):382-392. doi: 10.1016/j.ihj.2017.02.020. Epub 2017 Mar 6. PMID: 28648438; PMCID: PMC5485409.
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

3Houston, M. (2012), The Role of Nutraceutical Supplements in the Treatment of Dyslipidemia. The Journal of Clinical Hypertension, 14: 121-132. https://doi.org/10.1111/j.1751-7176.2011.00576.x

4Qin S, Huang L, Gong J, Shen S, Huang J, Ren H, Hu H. Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials. Nutr J. 2017 Oct 11;16(1):68. doi: 10.1186/s12937-017-0293-y. PMID: 29020971; PMCID: PMC5637251.
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

5Jamwal R. Bioavailable curcumin formulations: A review of pharmacokinetic studies in healthy volunteers. J Integr Med. 2018 Nov;16(6):367-374. doi: 10.1016/j.joim.2018.07.001. Epub 2018 Jul 4. Erratum in: J Integr Med. 2019 Jul;17(4):310. PMID: 30006023.

6Jorat, M. V., Tabrizi, R., Mirhosseini, N., Lankarani, K. B., Akbari, M., Heydari, S. T., Mottaghi, R., & Asemi, Z. (2018). The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Lipids in Health and Disease, 17(1), 230. https://doi.org/10.1186/s12944-018-0876-4
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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