[Secondary dyslipoproteinema in liver disease].
By far the most common dyslipoproteinema in patients with liver disease is hypertriglyceridemia with decreased HDL cholesterol occurring in fatty liver diseases. Since these latter frequently occur in patients with a metabolic syndrome, it must be assumed that lipid metabolism disorder is associated with a pronounced atherogenic effect. This means that--in contrast to cholestatic liver disease--treatment is almost always indicated. General therapeutic measures (weight reduction, optimization of blood sugar) are to the fore. As medication, metformin, fibrates and insulin sensitizers may be considered since, apart from improving glucose metabolism and hypertriglyceridemia, they also have a direct hepatic effect. It must, however, be noted that the available study data are not yet satisfactory, so that an individual decision must be made as to whether medical treatment of a lipid metabolism disorder makes good lipidological sense and is hepatologically justified.
Otto
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Medizinische Klinik II-Grosshadern, Klinikum der Universität München. mail@internist-dr-otto.de