Hyperlipidemia clinical presentation

In the course of the above-mentioned mechanisms Silics remains unchanged and thus preserves its activity during its residence in the intestine. Silics may also have promise in the clinical treatment for some internal diseases. The major lines of research into applications of this medicinal preparation in the relevant therapies are presented in Table 7. Of significance is the ability of Silics to lower cholesterol levels and triglycerides, as well as to retard aggregation of thrombocytes. Thus, with the help of Silics it becomes possible to treat the main pathogenic factors of atherosclerosis, namely hyperlipidemia and hypercoagulation (Table 7). 

Epidemiologic studies have indicated a very strong inverse association between HDL-cholesterol levels and the incidence of arteriosclerotic cardiovascular disease [32]. HDL is thought to promote efflux of cholesterol from peripheral cells in the vascular wall and return of that cholesterol to the liver for excretion in bile, a process known as reverse cholesterol transport [21]. HDL has also been shown to have anti-inflammatory and anti-thrombotic activities [21]. Therefore, HDL levels may influence both the hyperlipidemia and inflammatory processes proposed as factors in the development of atherosclerosis. Although clinical data in support of HDL-raising are limited, in the VA-HIT trial gemfibrozil therapy in men with coronary artery disease and low HDL-cholesterol modestly increased HDL levels and reduced coronary events by 22% [33]. Presently, other methods of effectively and safely increasing HDL-cholesterol levels have not been discovered. 

Comment - The reduction of serum lipids has now advanced to a functional clinical entity. Appropriate treatment of hyperlipidemia should become available on a routine basis as capability to perform phenotyping of hyperlipoproteinemias expands beyond its present limited environment of laboratories primarily devoted to lipid research. 

Three examples of the clinical applications are presented alteration of lipoprotein distribution for a patient with acute hepatitis according to recovery of disease (Fig. 23), change of HDL subfractions for a patient with coronary heart disease by a drug therapy (Fig. 24), and diagnosis of the type for hyperlipidemia by HPLC patterns (Fig. 25). 

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