| Hyperlipidemia in Chronic Cholestatic Liver Disease. | |
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MedLine Citation:
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PMID: 11469968 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Hyperlipidemia with a marked increase of low-density lipoprotein (LDL) and high- density lipoprotein (HDL) cholesterol levels is a common feature in patients with chronic cholestatic liver disease. Excess morbidity and mortality from cardiovascular disease has not been reported in these patients. This may be due to the particular lipoprotein pattern observed during chronic cholestasis, characterized by elevated serum HDL cholesterol, which may have a cardioprotective effect. However, in a subgroup of patients with chronic cholestasis, hyperlipidemia is characterized by markedly elevated LDL levels with normal or low HDL levels, probably reflecting hypercholesterolemia with coexisting familial and nutritional origins. Ursodeoxycholic acid, the only drug approved for the treatment of chronic cholestatic liver diseases, has been shown to slightly decrease serum cholesterol concentrations. However, the extent of LDL reduction by ursodeoxycholic acid may be insufficient to protect this subgroup of patients from increased cardiovascular risk. Patients in this subgroup probably would benefit from dietary modification, weight loss, and the administration of specific lipid-lowering drugs. Cholestyramine, which is the first-line treatment for pruritus in chronic cholestasis, may be also indicated for its cholesterol-lowering capacity in patients with hypercholesterolemia who complain of pruritus. Administration of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors (simvastatin or pravastatin, 20 mg/d) should be limited to hypercholesterolemic patients with mild chronic cholestatic liver diseases in whom HDL serum levels are below the protective range or if additional risk factors for cardiovascular diseases are present. |
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Authors:
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Matteo Longo; Andrea Crosignani; Mauro Podda |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Current treatment options in gastroenterology Volume: 4 ISSN: 1534-309X ISO Abbreviation: Curr Treat Options Gastroenterol Publication Date: 2001 Apr |
Date Detail:
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Created Date: 2001-Jul-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815941 Medline TA: Curr Treat Options Gastroenterol Country: - |
Other Details:
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Languages: ENG Pagination: 111-114 Citation Subset: - |
Affiliation:
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Division of Internal Medicine, Department of Medicine, Surgery, and Dentistry, San Paolo School of Medicine, University of Milan, Via di Rudini, 8, Milano 20142, Italy. mauro.podda@unimi.it |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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