Winter 2013 LipidSpin Articles | National Lipid Association Online

Kaye-Eileen Willard, MD, ABIM	Diagnosis and Genetic Variance in Familial Hypercholesterolemia The 1985 Nobel Prize in Physiology for Medicine was awarded to two physicians from Southwestern Medical Center in Dallas, Texas. Michael Brown, MD, and Joseph Goldstein, MD, received this honor "for their discoveries concerning the regulation of cholesterol metabolism."¹ They postulated that regulatory abnormalities of 3-hydroxy 3-methylglutaryl coenzyme A reductase were the cause of familial hypercholesterolemia (FH). This disorder had been known for many years, given the... more
PETER P. TOTH, MD, PhD, FNLA	From the NLA President: Momentum and Milestones Over the past several months, the NLA has made significant progress on a number of initiatives that reflect our commitment to advancing the science and practice of Clinical Lipidology. These initiatives also reflect the NLA's ambitions to see advances in our field manifest in new and innovative ways. This year, we opened the inaugural enrollment period for the Lifetime Membership program, which will ensure continuous membership in the association while helping to establish the... more
ALAN S. BROWN, MD, FACC, FAHA, FNLA	From the MWLA President: Making an Impact I am very grateful for the opportunity to be President of the Midwest Chapter of the National Lipid Association. During this year, the Midwest Chapter made a commitment to support the activities of both the NLA and the Foundation of the NLA. Because of that commitment, we have chosen topics for the Lipid Spin that align with the great work of the Foundation and address the timely topic of familial hypercholesterolemia. This common disorder is frequently undiagnosed, and therefore... more
JAMES A. UNDERBERG, MD, MS, FACPM, FACP, FNLA	Editor's Corner: A Time to Reflect With the end of the Thanksgiving weekend, I must reflect on recent events in New York City, and the impact they had on our medical infrastructure. I was finally filling my car up with gasoline and in front of me was a large pickup truck filling up a huge tank of gas. I asked what it was for and was told "fuel" for hospital generators in Staten Island, New York, that are still without electricity. It reminded me that while much in New York City has returned to normal, much has not.... more
LAXMANA M. GODISHALA, MD, FACP, FASH, FNLA	EBM Tools for Practice: Diabetes Optimal Care and Cardiovascular Risk Reduction According to the 2011 National Diabetes fact sheet, 25.8 million adults and children in the United States (8.3%) have diabetes and 79 million have pre-diabetes. In 2010 alone, 1.9 million new cases of diabetes were diagnosed. In 2007, the total cost of diagnosed diabetes was $174 billion and contributed to more than 231,000 deaths in the U.S.¹ Diabetes Means Cardiovascular Disease and More Diabetes mellitus (DM) leads to twofour times greater risk... more
SANFORD A. CARIMI, MD, FACP	Specialty Corner: Pediatric FH Guidelines for the Adult Lipidologist As an Internist who specialized in adult medicine, I had not seen many pediatric patients since my days in medical school. Now, however, as a Clinical Lipidologist, I have had the opportunity on a few occasions to evaluate a child or young adolescent with markedly elevated LDL cholesterol referred by pediatric and family medicine colleagues. Despite the increase prevalence of childhood obesity, diabetes, and dyslipidemia, these problems are still best treated by lifestyle changes of... more
Janet L. Maxson, PhD, FNP, FAHA, FNLA JANET L. MAXSON, PhD, FNP, FAHA, FNLA	Practical Pearls: Broken Hearts or Broken Bones? The primary health care of women is a complex world of "Hearts, Hormones, Ovaries, Breasts and Bones." Over the past year women have expressed concern when reading articles and listening to media reports that suggest taking calcium supplements may help prevent fractures but at the same time may increase their risk for cardiovascular events. The Nurses' Health Study reported calcium supplement intake increased from 30% in 1984 to 72% in 2004. What is the evidence to bring to... more
Edwin E. Ferguson, MD, FNLA	Case Study 1: Chronic Kidney Disease and the Heart - Conjoined Twins? Why Identifying Early and Progressive Kidney Disease Matters Over 26 million Americans have chronic kidney disease (CKD). At risk for CKD include 65 million Americans with hypertension and 20 million patients with diabetes mellitus. The risk of cardiovascular disease (CVD), including coronary, cerebrovascular, peripheral vascular disease, and congestive heart failure increases by 3-to-20-fold as CKD progresses. The staging of CKD, and slowing (or potentially halting) the progression of CKD through its five stages (Table 1) are paramount, but... more
Kevin C. Maki, PhD, CLS, FNLA Mary R. Dicklin, PhD	Lipid Luminations: Emerging Therapies for Familial Hypercholesterolemia Familial hypercholesterolemia (FH) is a disease caused by autosomal dominant defects in the genes coding for the lowdensity lipoprotein (LDL) receptor, apolipoprotein (Apo) B, or proprotein convertase subtilisin/kexin type 9 (PCSK9).¹ It is the most common single gene lipid disorder. FH is characterized by severely elevated blood cholesterol concentrations. Xanthelasmas, tendon xanthomas, tuberous xanthomas, and corneal arcus may be evident upon physical examination of FH patients... more
ALAN S. BROWN, MD, FACC, FAHA, FNLA	Case Study II: Hereditary Sitosterolemia This 58-year-old patient was referred to the lipid clinic for statin intolerance and a history of "genetic hypercholesterolemia." The patient has had tendon xanthomas on the extensor surface of his hands and on his Achilles tendons since childhood just like his brother and sister. Both siblings have expired prematurely due to coronary artery disease. He states that he has had a biopsy of his Achilles tendon that revealed "cholesterol" deposition by pathology per his... more
TARA L. DALL, MD, FNLA	Member Spotlight: Tara L. Dall, MD When Tara Dall, MD, began her medical career, it was in 2001, after she graduated from medical school and completed her residency at the University of Wisconsin at Madison. She started as a family practice physician with no specialization in lipidology. That changed quickly, however, when she saw how much lipid management impacted her patients’ everyday lives. "I began using advanced biomarkers, such as NMR and apoB, in most patients from the day I started my primary care... more
ANNE C. GOLDBERG, MD, FNLA	Foundation Update The Foundation of the National Lipid Association has accomplished much since its creation four years ago, but we want to continue to grow. Over the past year, I have been engaged in conversations with leadership, members, staff and patients about the future of our charitable organization. As we look ahead to the way the Foundation will define its agenda in the coming years, several themes consistently emerge. ... more