Comprehensive Explanation of Common Blood Lipid Problems: From Definition to Hazards and Control Methods

Frequently Asked Questions about Blood Lipids:

1. What are Blood Lipids? Blood lipids are the collective term for cholesterol (TC), triglycerides (TG), and lipids (such as phospholipids) in serum. Blood lipids are insoluble in water and must bind to apolipoproteins to form lipoproteins before they can dissolve in the blood and be transported to tissues for metabolism. Lipoproteins are classified into chylomicrons (CM), very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). There is also a type of lipoprotein called lipoprotein(a) [LP(a)]. Clinically, low-density lipoprotein cholesterol (LDL-C) is of most concern, as this indicator is closely related to the occurrence of cardiovascular disease.

2. What are the Dangers of High Blood Lipids? Atherosclerotic plaques are a major cause of coronary heart disease, myocardial infarction, and cerebral infarction. Elevated blood lipids, especially elevated low-density lipoprotein cholesterol, are an important factor in the formation of atherosclerosis. The higher the level, the easier it is for plaques to form, and the greater the risk of cardiovascular disease.

3. Will not eating meat prevent high blood lipids?

Blood lipids come from many sources. Approximately one-third comes from dietary intake, and two-thirds are synthesized by the liver and other organs. If lipid intake decreases, the liver and other organs will increase synthesis. Besides increased synthesis, high blood lipids are also related to decreased metabolism. Many elderly people who have been vegetarian for a long time, as well as some thin people, also experience elevated blood lipids due to metabolic disorders and genetic factors.

4. Are there symptoms of high blood lipids? Mild to moderate high blood lipids generally do not cause symptoms. Severe high blood lipids may cause dizziness, chest tightness, fatigue, and drowsiness. In severe cases, it can lead to serious diseases such as cerebral infarction and myocardial infarction.

5. Can fish oil help improve blood lipids? Statins are currently the most effective drugs for lowering blood lipids and improving the prognosis of cardiovascular disease patients. Data on fish oil's blood lipid-lowering effects is limited. The results of two fish oil studies presented at the 2020 American Heart Association Scientific Sessions concluded that fish oil preparations do not reduce adverse cardiac events in recent elderly myocardial infarction survivors. However, in 2021, the European Medicines Agency's Committee for Medicinal Products for Human Use recommended approval for high-purity fish oil preparations for high-risk cardiovascular patients to reduce the risk of cardiovascular events. Currently, more research results have found that high-purity fish oil can lower triglycerides.

In summary, Dr. Zhou suggests that if you want to lower blood lipids and stabilize plaques, you must take statins. Fish oil can only be used as an adjunct to lower triglycerides.

6. What does elevated transaminase mean? Current research shows that about 3% of patients treated with statins experience a slight increase in transaminase levels, usually a transient increase within 3 months of starting treatment, followed by a gradual return to normal. The mechanism by which statins cause elevated transaminase levels is still unclear. It may be due to changes in the structure of hepatocyte membranes caused by statins, leading to the leakage of liver enzymes and a decrease in cholesterol levels, resulting in a secondary drug effect. For asymptomatic patients, if transaminase levels are mildly elevated, there is no need to stop medication. However, if transaminase levels rise more than three times the normal level or bilirubin levels are elevated, the possibility of liver damage is higher, and the dosage can be reduced or medication discontinued under the guidance of a doctor.