According to abbreviationfinder, TIHP stands for Type III hyperlipidemia. Type III hyperlipidemia or familial dysbetalipoproteinemia is a genetic lipid metabolism disorder in which cholesterol and triglyceride levels in the blood are elevated. Type III hyperlipidemia is a significant risk factor for arteriosclerosis, vascular occlusion and coronary heart disease.
What is type III hyperlipidemia?
Type III hyperlipidemia is initially noticeable through increased blood lipid levels. Physically, this increase is reflected, among other things, by the typical orange-yellow skin changes, which increase as the disease progresses and are often accompanied by paleness and sunken eye sockets.
Type III hyperlipidemia is a rare, genetically determined lipid metabolism disease in which there is an increased concentration of certain lipoproteins in the serum. Due to a disturbed fat metabolism, lipid breakdown is only possible to a limited extent, which is why in hyperlipidemia type III both the cholesterol (hypercholesterolaemia) and the triglyceride value (hypertriglyceridaemia) are increased (combined hyperlipidaemia).
Hyperlipidemia type III is referred to here when the blood levels of these lipid components are over 200 mg/dl. Type III hyperlipidemia is externally manifested by xanthoma, yellowish nodules on the skin caused by local lipid deposits. In addition, the increased lipoprotein concentration in the blood present in type III hyperlipidemia leads to arteriosclerosis and coronary heart disease in the long term.
Type III hyperlipidemia is genetic and can be traced back to an autosomal dominant (rarely autosomal recessive) inherited damage to the so-called apolipoprotein E. Apolipoprotein E, as a component of some lipoproteins, regulates hepatic uptake of chylomicron and VLDL remnants.
Chylomicron and VLDL remnants consist mainly of triglycerides and cholesterol and regulate the transport of lipids from the liver to other organs. This metabolic process is disturbed by the presence of an abnormal apolipoprotein E, so that the concentration of cholesterol and triglycerides in the blood is increased. These substances are deposited on the blood vessel walls and form arteriosclerotic plaques, which increasingly increase the risk of occlusive diseases, strokes and coronary heart disease.
However, type III hyperlipidemia develops in only about 4 percent of genetically predisposed individuals. Other secondary factors such as estrogen deficiency, adiposity (obesity), excessive alcohol consumption as well as hypothyroidism (underactive thyroid gland) and diabetes mellitus play an important role in the manifestation of hyperlipidemia type III.
Symptoms, Ailments & Signs
Type III hyperlipidemia is initially noticeable through increased blood lipid levels. Physically, this increase is reflected, among other things, by the typical orange-yellow skin changes, which increase as the disease progresses and are often accompanied by paleness and sunken eye sockets. They usually appear between the fingers, on the knees, elbows or on the buttocks and back.
In individual cases, deposits also occur on the eyelids. The fat deposits do not normally cause any further symptoms, but they can promote circulatory disorders. In any case, they are a warning sign that must be clarified by a doctor. If no treatment is given, problems with the cardiovascular system and blood vessels can occur. Possible consequences are a heart attack, circulatory disorders in the brain and a stroke.
In the long term, peripheral arterial occlusive disease can develop, which manifests itself, among other things, in pain when moving, wound healing disorders and a general decrease in physical performance. Type III hyperlipidemia impairs many endogenous processes and increases the risk of various diseases. Acute symptoms usually do not occur, but the patients often feel an increasing feeling of illness, usually associated with pain in the chest area and numbness in the fingers and toes.
Diagnosis & History
The diagnosis of type III hyperlipidemia is based on a blood analysis, which determines the proportions of chylomicron and VLDL (very low density lipoprotein) and thus indirectly of cholesterol and triglycerides in the serum.
If the values are elevated, the diagnosis of hyperlipidemia type III is considered to be certain. In some cases, ultracentrifugation or lipoprotein electrophoresis is used to precisely quantify the individual lipoprotein components. In addition, the underlying genetic defect can be determined as part of a genetic test.
If left untreated, type III hyperlipidemia can lead to serious vascular disease (arteriosclerosis), coronary heart disease and cardiac events. As a rule, the course of hyperlipidemia type III can be positively influenced as part of therapy.
Type III hyperlipidemia can lead to an increased risk of heart disease or vascular occlusion. In the worst case, the patient can die from heart problems. This leads to fat deposits on the fingers, which usually turn yellowish and orange.
These complaints often lead to depression and inferiority complexes, since these symptoms are considered unaesthetic. It is not uncommon for children to be teased and bullied. Furthermore, the patient suffers from circulatory disorders, so that, for example, the extremities suffer from an insufficient supply of oxygen.
This undersupply can lead to permanent and irreversible damage to the extremities and other regions of the body. In some cases, type III hyperlipidemia leads to restricted mobility and thus to a reduced quality of life. In most cases, type III hyperlipidemia can be controlled relatively well.
The treatment takes place mainly with medication and does not lead to further compilations. However, the affected person is dependent on a healthy lifestyle. With prompt and positive treatment, the patient’s life expectancy will not be reduced by the disease.
When should you go to the doctor?
People who notice yellow-orange fatty deposits on their hands and fingers should see a doctor. The noticeable skin changes indicate a serious condition that needs to be examined and treated if necessary. Type III hyperlipidemia is usually treated immediately, as the disease can cause various complications if left untreated. Therefore, if familial dysbetalipoproteinemia is suspected, you should go to your family doctor immediately. Medical advice is required at the latest when xanthomas and signs of circulatory disorders appear.
Damage to the extremities and other body regions must be clarified immediately. If mental problems should arise as a result of the aesthetic changes, psychological advice is required. The patient should also contact a nutritionist and work out an individual diet together with them. In principle, type III hyperlipidemia is easily treatable if it is detected early. Because the condition is genetic, people with a family history of hyperlipidemia should have early genetic testing.
Treatment & Therapy
Type III hyperlipidemia is usually treated with medication and diet. The therapeutic measures are primarily aimed at weight reduction through a change in diet to vegetable, unsaturated fats.
Dietary measures only have a strong reducing effect on triglyceride levels but not on cholesterol levels, since only 15 percent of cholesterol is ingested with food. If necessary, combined or monotherapeutic medicinal lipid -lowering drugs (including colestipol, lovastatin, nicotinic acid, sitosterol, clofibric acid, omega fatty acids) and plasmapheresis are used to lower cholesterol levels.
Lipid-lowering drugs bring about a reduction in elevated blood lipids via various mechanisms by inhibiting the formation of cholesterol or Intervene in lipoprotein synthesis or lower cholesterol or triglycerides directly. In a therapeutic plasmapheresis, the patient’s own plasma is separated from the blood, cleaned and the essential components are replaced with a substitution solution.
In addition, regular physical activity and exercise are recommended to help reduce cholesterol levels. In principle, the secondary factors involved in the manifestation of type III hyperlipidemia should be treated simultaneously. If underlying diseases such as diabetes mellitus or hypothyroidism have triggered type III hyperlipidemia, more comprehensive therapeutic measures are required.
Outlook & Forecast
Although type III hyperlipidemia cannot be cured due to its genetic condition, it is easily treatable. With long-term therapy and a healthy lifestyle, a good prognosis can be assumed. Without treatment, however, life expectancy is slightly lower than that of the general population. As a result of type III hyperlipidemia, severe arteriosclerosis develops, which can quickly lead to heart attacks, strokes or arterial occlusive disease (intermittent claudication).
It is also important for the prognosis whether the gene mutation is autosomal recessive or autosomal dominant. In the case of an autosomal recessive inheritance, preventive measures can still prevent the onset of the disease. This is different with autosomal dominant inheritance. This gene mutation definitely leads to the onset of the disease. Type III hyperlipidemia is usually treatable with therapy. The life expectancy of those affected can be increased and match the level in the normal population.
The therapy consists of a combination of measures consisting of drug treatment and a change in lifestyle. The most important goal of the therapy is to lower cholesterol levels, which, in addition to the administration of cholesterol-lowering drugs, includes measures such as weight loss if overweight, lots of exercise in the fresh air, a change in diet and abstinence from smoking and alcohol. This significantly reduces the risk of arteriosclerosis and its complications.
Direct preventive measures are only possible to a limited extent in the case of hyperlipidemia type III, since the disease is genetic. However, by avoiding secondary factors, a possible manifestation of hyperlipidemia type III can be counteracted. A low-calorie and low-fat diet, physical activity, and limited alcohol and nicotine consumption are among the preventive measures for manifestation of type III hyperlipidemia.
In the case of type III hyperlipidemia, follow-up measures are severely limited in most cases. The focus here is on early detection and treatment of the disease, which prevents further complications or a further deterioration of the symptoms. This disease cannot heal itself, which means that untreated type III hyperlipidemia can, in the worst case, lead to a reduced life expectancy for those affected.
In most cases, a healthy lifestyle with a healthy diet has a very positive effect on the further course of this disease. This also includes avoiding obesity and also not smoking or drinking alcohol. It is also not uncommon for medication to be taken. It is important to ensure that it is taken regularly with the correct dosage in order to properly alleviate the symptoms.
If anything is unclear or if you have any questions, you should always contact a doctor first. In some cases of type III hyperlipidemia, the help and support of one’s own family is also necessary in order to properly alleviate the symptoms and possibly also to prevent mental disorders or depression. Contact with other patients with the disease can also be very useful.
You can do that yourself
Since type III hyperlipidemia is genetic, direct treatment of the disease is usually not possible. However, those affected can limit the symptoms and symptoms of the disease by adopting a healthy lifestyle.
Especially a low-fat dietand sufficient physical activity can have a positive effect on the disease. Furthermore, patients with hyperlipidemia type III should avoid tobacco or alcohol. If the person concerned is overweight, this must be reduced in any case. Sporting activities in groups or with friends can be very helpful. As a rule, patients are also dependent on taking medication. These should be taken regularly to limit cholesterol levels as well. Those affected often also suffer from diabetes due to type III hyperlipidemia, so that this disease also has to be treated. A healthy diet and a strict diet also have a very positive effect on the course of the disease.
In order to avoid further complications or circulatory disorders, the patients should also take part in regular examinations. The examination of the blood in particular can provide important results.