6
Description of Conditions
Risk Factors
• Notable risk factors include family history of premature
cardiovascular disease, diabetes mellitus, hypertension, smoking,
and obesity. The assessment should consist of total cholesterol, LDL
cholesterol, HDL cholesterol, and triglycerides (TG) after a 9- to 12-
hour fast; nonfasting lipid profiles are acceptable for initial screening.
Dyslipidemia
➤ Visceral adiposity in obesity drives atherogenic dyslipidemia
through chronic inflammation, increased hepatic free fatty acid
flux, and adipokine imbalances, leading to elevated very low-
density lipoprotein (VLDL), reduced high-density lipoprotein
(HDL), and small, dense low-density lipoprotein (LDL) particles,
which in turn heighten cardiovascular risk.
➤ Clinical Manifestations
• Most cases are asymptomatic and detected by screening.
Patients with obesity-related dyslipidemia may present with
xanthomas, xanthelasma, corneal arcus, or signs of atherosclerotic
cardiovascular disease (ASCVD). However, dyslipidemia is typically
asymptomatic until advanced cardiovascular complications
develop, emphasizing the importance of systematic screening.
➤ Screening
• The 2026 American College of Cardiology (ACC)/American Heart
Association (AHA) Guideline on the Management of Dyslipidemia
recommends universal lipid screening beginning at age 19
years and at least every 5 years thereafter to identify treatable
atherosclerotic cardiovascular disease (ASCVD) risk, with more
f requent screening for individuals with additional ASCVD risk
factors. For pediatric populations, the guidelines recommend
screening children ages 9 to 11 years with a lipid prof ile to identify
familial hypercholesterolemia (FH) and other signif icant lipid
disorders.
