Hyperlipidemia is a heterogeneous group of disorders characterized by an excess of lipids in the bloodstream. The concentrations of lipids, such as triglycerides (TG), cholesterol (TC) and low density lipoprotein (LDL) increase or the level of high density lipoprotein (HDL) decrease in the blood. Hyperlipidemia is becoming a major health problem in the world recently even in human and companion animal clinic.

Keywords: Lipids, Hyperlipidemia, High fat diet, Cholesterol

INTRODUCTION

Hyperlipidemia is modifiable risk factor for atherosclerosis and related cardiovascular diseases, including coronary heart disease, cerebral stroke, myocardial infarction and renal failure are becoming a major health problem in the world recently [1]. These lipids include cholesterol, cholesterol esters, phospholipids and triglycerides. Increased levels of LDL are related to the development of atherosclerosis [2,3]. HDL plays an important role in removing cholesterol from tissues and protecting against cardiovascular disease.

Jacobson [3] reported that hyperlipidemia refers to elevated levels of lipids and cholesterol in the blood and it is also identified as dyslipidemia, to describe the manifestations of different disorders of lipoprotein metabolism. The term hyperlipidemia refers to increased concentrations of lipids (triglycerides, cholesterol or both) in the blood stream, increased blood concentrations of triglycerides referred to as hypertriglyceridemia, while increased blood concentrations of cholesterol are referred to as hypercholesterolemia [1,4-6]. Another related condition, dyslipidemia indicates disorders of lipoprotein metabolism, including lipoprotein overproduction or deficiency. These disorders may manifest with the elevation of serum total cholesterol, Low-Density Lipoprotein (LDL), triglyceride concentrations and a decrease in the High Density Lipoprotein (HDL) concentration. The main aim of treatment hyperlipidemia is to reduce the risk of developing ischemic heart disease, cardiovascular and cerebrovascular disease.

REASON OF HYPERLIPIDEMIA

Dietary intake may not be the major source of cholesterol, of which 80% is synthesized in the body. It may be true that dietary intake affects the amount of total cholesterol somewhat [7], but it can also be synthesized endogenously by the liver and other tissues. Several diseases have been reported to cause hyperlipidemia. Endocrine disease most commonly, canine hyperlipidemia is the result of an endocrine disorder, such as hypothyroidism, diabetes mellitus or hyperadrenocorticism [6,8-10].

Hyperlipidemia can be the result of an inherited disease in certain breeds of dogs [8]. In pets, hyperlipidemia most often occurs as a consequence of some disorder, hyperlipidemia even can also occur spontaneously after a meal of high-fat diet, particularly table scraps [9,10]. Hyperlipidemia is seen most commonly in ponies, miniature horses, and donkeys, and less frequently in standard-size adult horses [11]. In non-ruminants, including primates and man, hyperlipidemia may be increased by dietary manipulations such as feeding excessive cholesterol or fats with high saturated fatty acid content [12-17]. 

DISCUSSION

Hyperlipidemia is a major modifiable risk factor for atherosclerosis and cardiovascular disease. Increased levels of LDL are related to the development of atherosclerosis [6,13]. HDL plays an important role in removing cholesterol from tissues and protecting against cardiovascular disease.

Karam [18,19] reported that the hyperlipidemia disease model was constructed successfully in rats by feeding with high fat diet. Causing histopathological changes in liver was partly supported by H&E staining and indicated that a high fat diet accumulated fat in hepatic tissue cells [16]. High fat diet can finally cause fatty liver. That means high fat diet successfully induced hyperlipidemia in rats [17]. Certainly, these changes may be able to be explained in part by the elevated cholic acids. Cholic acid is synthesized in the liver and secreted in the gallbladder or intestine [18].

There are many chemical drugs that could ameliorate hyperlipidemia such as: statins, fibrates, ezetimibe and nicotinic acid, but most of them are expensive and have undesirable effect [19]. Many herbal medicinal products were reported to have a potential to reduce lipid and cholesterol in body and to enhance the safety profile by elevating HDL levels and inhibiting lipid oxidation, such as Berberine which had regulation effect on hyperlipidemia indexes [20-23]. The major portion of the global population in developing countries still relies on botanical drugs to meet its health needs [22]. The attention paid by health authorities to the use of herbal medicines has increased considerably, because herbal medicines they are often only medicine available in less developed areas and because they are becoming a popular alternative treatment in more developed areas [20].

So there are increasing interest in alternative drug for the prevention and treatment of hyperlipidemia. Currently available hyperlipidemic drugs have been associated with a number of side effects. Therefore, now it’s important to search for drug that is less toxic, less expensive, which can provide better safety and efficacy on a long term usage.

1.       Xu QY, Liu YH, Zhang Q, Ma B, Yang ZD, et al. (2014) Metabolomic analysis of simvastatin and fenofibrate intervention in high-lipid diet-induced hyperlipidemia rats. Acta Pharmacologica Sinica 35: 1265.

2.       Smith SC, Jackson R, Pearson TA, Fuster V, Yusuf S, et al. (2004) Principles for national and regional guidelines on cardiovascular disease prevention: A scientific statement from the World Heart and Stroke Forum. Circulation 109: 3112-3121.

3.       Jacobson MS (1998) Heart healthy diets for all children: No longer controversial. J Pediatr 133: 1-2.

4.       Watson T, Barrie J (1993) Lipoprotein metabolism and hyperlipidemia in the clog and cat: A review. J Small Anim Pract 34: 479-487.

5.       Ford RB (1996) Clinical management of lipemic patients. The Compendium on continuing education for the practicing veterinarian (USA).

6.       Johnson MC (2005) Hyperlipidemia disorders in dogs. Compendium 27: 361-370.

7.       Ahn J, Kim NS, Lee BK, Park S (2017) Carbohydrate intake exhibited a positive association with the risk of metabolic syndrome in both semi-quantitative food frequency questionnaires and 24 h recall in women. J Korean Med Sci 32: 1474-1483.

8.       Xenoulis PG, Steiner JM (2010) Lipid metabolism and hyperlipidemia in dogs. Vet J 183: 12-21.

9.       Whitney M (1992) Evaluation of hyperlipidemias in dogs and cats. Semin Vet Med Surg.

10.    Bauer JE (2004) Lipoprotein-mediated transport of dietary and synthesized lipids and lipid abnormalities of dogs and cats. J Am Vet Med Assoc 224: 668-675.

11.    Durham A (2006) Clinical application of parenteral nutrition in the treatment of five ponies and one donkey with hyperlipemia. Vet Record 158:159-64.

12.    Nestel P, Poyser A, Hood R, Mills S, Willis M, et al. (1978) The effect of dietary fat supplements on cholesterol metabolism in ruminants. J Lipid Res 19: 899-909.

13.    Smith S, Voûte J, Fuster V (2006) Principles for national and regional guidelines on cardiovascular disease prevention. Nature Publishing Group.

14.    Feng LJ, Yu CH, Ying KJ, Hua J, Dai XY, et al. (2011) Hypolipidemic and antioxidant effects of total flavonoids of Perilla frutescens leaves in hyperlipidemia rats induced by high-fat diet. Food Res Int 44: 404-409.

15.    Ma N, Karam I, Liu XW, Kong XJ, Qin Z, et al. (2017) UPLC-Q-TOF/MS-based urine and plasma metabonomics study on the ameliorative effects of aspirin eugenol ester in hyperlipidemia rats. Toxicol Appl Pharmacol 332: 40-51.

16.    Wu Q, Zhang H, Dong X, Chen XF, Zhu ZY, et al. (2014) UPLC-Q-TOF/MS based metabolomic profiling of serum and urine of hyperlipidemic rats induced by high fat diet. J Pharm Anal 4: 360-367.

17.    Stein EA, Lane M (1998) Comparison of statins in hypertriglyceridemia. Am J Cardiol 81: 66B-69B.

18.    Karam I, Ma N, Liu XW, Li SH, Kong XJ, et al. (2015) Regulation effect of aspirin eugenol ester on blood lipids in Wistar rats with hyperlipidemia. BMC Vet Res 11: 217.

19.    Karam I, Ma N, Liu XW, Kong XJ, Zhao XL, et al. (2016) Lowering effects of aspirin eugenol ester on blood lipids in rats with high fat diet. Lipids Health Dis 15: 196.

20.    Xiao HB, Sun ZL, Zhang HB, Zhang DS (2012) Berberine inhibits dyslipidemia in C57BL/6 mice with lipopolysaccharide induced inflammation. Pharmacol Rep 64: 889-895.

21.    Zhang X, Wu C, Wu H, Sheng L, Su Y, et al. (2013) Anti-hyperlipidemic effects and potential mechanisms of action of the caffeoylquinic acid-rich Pandanus tectorius fruit extract in hamsters fed a high fat-diet. PLoS One 8: e61922.

22.    Thomas S (2003) Medications that lower cholesterol. J Lipid Res 33: 79-82.

23.    Dou XB, Fan CL (2008) Progress of research in treatment of hyperlipidemia by monomer or compound recipe of Chinese herbal medicine. Chin J Integr Med 14: 71-75.