Hypolipidemia: A word of caution

Abstract

Hypolipidemia is a decrease in plasma lipoprotein caused by primary (genetic) or secondary (acquired) factors. It is usually asymptomatic and diagnosed incidentally on routine lipid screening. The first report of hypocholesterolemia in the medical literature was in 1911 by Chauffard and coworkers, in patients with active tuberculosis [1]. Since then (about 95 years), only few dozens of studies were published in this regard. Unlike hyperlipidemia physicians are usually unaware of hypolipidemia, its causes and consequences. As the interest in aggressive management of hyperlipidemia increases, particularly with the available, relatively strong hypolipidemic drugs and the newer and probably stronger agents, the following question should be answered; how low can we go in serum levels. For the time being, it is difficult to give a certain limit for the safest and lowest level of serum cholesterol, but knowing the complications of hypolipidemia will raise awareness. What might appear as a simple mildly reduced serum lipid can be an indication of an underlying, serious problem. A systematic search of Pubmed for all the studies in the English language as well as the abstracts of publications in other languages related to hypolipidemia was undertaken. The following words were used in the search: hypolipidemia, hypocholesterolemia, hypobetalipoproteinemia, and statins. Search results were reviewed.