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Xanthelasma palpebrarum.jpg
Yellowish patch consisting of cholesterol above the eyelids. These are more common in people with familial hypercholesterolemia.
SymptomsNone, yellowish lipid deposits in the skin[1][2]
ComplicationsHeart disease, stroke, pancreatitis[1][2]
TypesPhenotype I, IIa, IIb, III, IV, V[1]
Risk factorsGenetics, poor diet, inactivity, obesity, smoking, diabetes, nephrotic syndrome, biliary obstruction, hypothyroidism, certain medications[1][2]
Diagnostic methodBlood tests for total, LDL, and HDL cholesterol, and triglycerides[1]
TreatmentLifestyle changes, medications[1]

Dyslipidemia is an abnormal amount of lipids (fats) in the blood.[1] It is divided into six types which result in some combination of high total cholesterol, high LDL cholesterol, low HDL cholesterol, high triglycerides, or high apolipoprotein B.[1] There are generally no symptoms, though occasionally yellowish lipid deposits within the skin occur.[1][2] Complications may include heart disease, stroke, and pancreatitis.[1][2]

Causes may include poor diet, inactivity, obesity, excessive alcohol, and smoking.[1][2] Other health conditions that can result in dyslipiedmia include diabetes, nephrotic syndrome, biliary obstruction, hypothyroidism, and certain medications.[1][2] Some types run in families such as familial hypercholesterolemia.[1] Diagnosis is generally by blood tests for total, LDL, and HDL cholesterol, and triglycerides.[1]

Treatment involves lifestyle changes including a diet high in vegetables and exercise.[1] Other treatments depend in part on the types of dyslipidemia.[2] If medications are used, the initial choice is generally a statin.[1] Dyslipidemia becomes more common with age.[1] In the United States high cholesterol affects about 34% of those over the age of 20.[1]


Increases Decreases


An example of dyslipidemia in the form of a 4-ml sample of hyperlipidemic blood in a vacutainer with EDTA. Left to settle for four hours without centrifugation, the lipids separated into the top fraction.


Dyslipidemias are classified in two ways:

  • Presentation in the body (including the specific type of lipid that is increased)
  • Underlying cause for the condition (genetic, or another condition).[2] This classification can be problematic, because most conditions involve the intersection of genetics and lifestyle issues. However, there are a few well-defined genetic conditions that are usually easy to identify.

Fredrickson Classification:[3][1]

Phenotype I IIa IIb III IV V
Elevated lipoprotein Chylomicron LDL LDL and VLDL IDL VLDL VLDL and chylomicrons


Testing the general population under the age of 40 without symptoms is of unclear benefit.[4][5] Testing is not needed more often than every 10 years at most.[6] These can be done non fasting.[6]


A Mediterranean diet and exercise is recommended.[6]


If medications are used the first line treatment is generally statins.[1] With statins, the goal is to increase the medication to a specific dose, rather than adjust the medication to a cholesterol level.[6]

Other medications that can be used include ezetimibe.[1] Fibrates may be used for high blood triglycerides.[2] When used together with statins they may cause muscle breakdown.[1]


  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 Pappan, N; Rehman, A (January 2020). "Dyslipidemia". PMID 32809726. {{cite journal}}: Cite journal requires |journal= (help)
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 "Dyslipidemia - Endocrine and Metabolic Disorders". Merck Manuals Professional Edition. Archived from the original on 19 November 2020. Retrieved 20 November 2020.
  3. Fredrickson DS, Lees RS. A system for phenotyping hyperlipoproteinemia. Circulation 1965;31:321-327.
  4. Bibbins-Domingo, Kirsten; Grossman, David C.; Curry, Susan J.; Davidson, Karina W.; Epling, John W.; García, Francisco A. R.; Gillman, Matthew W.; Kemper, Alex R.; Krist, Alex H.; Kurth, Ann E.; Landefeld, C. Seth; Lefevre, Michael; Mangione, Carol M.; Owens, Douglas K.; Phillips, William R.; Phipps, Maureen G.; Pignone, Michael P.; Siu, Albert L.; Siu, A. L. (August 9, 2016). "Screening for Lipid Disorders in Children and Adolescents". JAMA. 316 (6): 625–33. doi:10.1001/jama.2016.9852. PMID 27532917.
  5. Chou, R; Dana, T; Blazina, I; Daeges, M; Bougatsos, C; Jeanne, TL (18 October 2016). "Screening for Dyslipidemia in Younger Adults: A Systematic Review for the U.S. Preventive Services Task Force". Annals of Internal Medicine. 165 (8): 560–564. doi:10.7326/m16-0946. PMID 27538032.
  6. 6.0 6.1 6.2 6.3 O'Malley, Patrick G.; Arnold, Michael J.; Kelley, Cathy; Spacek, Lance; Buelt, Andrew; Natarajan, Sundar; Donahue, Mark P.; Vagichev, Elena; Ballard-Hernandez, Jennifer; Logan, Amanda; Thomas, Lauren; Ritter, Joan; Neubauer, Brian E.; Downs, John R. (22 September 2020). "Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline". Annals of Internal Medicine. doi:10.7326/M20-4648.

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