Lipid Management in Patients with Endocrine Disorders
Key Points
Key Points
- Obtain a lipid panel in adults with endocrine disorders to assess triglyceride (TG) levels and to calculate LDL cholesterol (LDL-C).
- Treat adults with type 2 diabetes (T2D) and other cardiovascular (CV) risk factors with a statin in addition to lifestyle modifications, aiming for an LDL-C goal of <70 mg/dL.
- Consider statin therapy, irrespective of the CV risk score, in adults with type 1 diabetes who are age 40 years and older, or have a history of diabetes of at least 20 years, or either microvascular complications, chronic kidney disease (CKD) stages 1-4, or obesity.
- Rule out hypothyroidism in patients with hyperlipidemia before treatment with lipid lowering medications. In patients with hypothyroidism re-evaluate the lipid profile when the patient is euthyroid.
- Consider statin therapy as adjunct to lifestyle modifications in adults with persistent endogenous Cushing’s syndrome or adults taking chronic glucocorticoid therapy above replacement levels.
- For treatment of dyslipidemia in post-menopausal women, use statins, rather than hormone therapy, because statins reduce atherosclerotic cardiovascular disease (ASCVD).
- Evaluate and treat lipids and other CV risk factors in women who enter menopause early (before the age of 40-45 years).
Assessment
...essment...
...g and Cardiovascular Disease Risk Ass...
...easurement of Lipids1.1 In adults with endocrine...
...Lipids and Lipoproteins in Select...
CV Risk Assessment
...In adults with endocrine disorders, we recommend c...
...with endocrine disorders at border...
...t patients with a family history of prematur...
...ble 2. Assessment of ASCVD Risk in Patients wit...
...re 1. CVD Events per 1,000 Person-Years by...
...ed Decision-Making Approach to Selective Use of...
Hypertriglyceridemia
...ertriglyceridemia...
...pertriglyceridemia...
...adults with fasting TG levels over 500...
In patients with triglyceride-induced pancreat...
...ts without diabetes who have TG-ind...
....4 In adults who are on statins an...
...atients with elevated TG (>150 mg/dL to 499 mg...
Diabetes
...abetes...
.... Type 2 Diabetes Me...
3.1 In adults with T2D and other CV ri...
...ults with T2D and other CV risk fac...
...adults with T2D on a statin at LDL...
...s with T2D with chronic kidney disease stages 1–...
...ts with T2D and diabetic retinopathy, we su...
.... Type 1 Diabetes Mellitu...
...ts with type 1 diabetes (T1D) age 40 years...
...lts with T1D with CKD in stages 1–4, we sugges...
...lts with T1D with obesity, or with high TG a...
...adults with T1D and diabetic retinop...
Obesity
Obesity
...Obesity...
...n individuals who have obesity, we advise asse...
...individuals who have obesity, we suggest lif...
...individuals who have obesity, we recommend...
...ls who have obesity and are on pharm...
...uals with obesity, (body mass index >40 or >...
Other Conditions
...her Conditions
...yroid Diseas...
...n patients with hyperlipidemia, we recommend r...
...In patients with hyperthyroidism, we...
...atients with overt hypothyroidism, we s...
...atients with subclinical hypothyroidism...
...xcess Glucocorticoids...
Lipid-Lowering Therapy in Cushing...
...with persistent endogenous Cushing syndr...
...ith cured Cushing syndrome, we adv...
...ipid Management in Chronic Glucoco...
...dults receiving chronic glucocorticoid therapy...
.... Disorders Of Growth Hormone Secretio...
...dult Growth Hormone Deficiency...
...ts with GHD, we recommend obtaining a lipid prof...
...ith GHD associated with hypopituitarism, we s...
...t patients with GHD, we recommend against usin...
...owth Hormone Excess (Ac...
...n adults with acromegaly, we suggest measurement...
...Polycystic Ovary Syndrome
...Abnormalities...
...men with polycystic ovary syndrome...
...ovascular Risk...
...reatment of PCOS on lipids9.2 In women with PCO...
...opause And Hormonal Replacement
...pausal women, we recommend treating dys...
...nopausal women on hormone therapy and with ot...
...n women who enter menopause early (...
...nadism and Testosterone Replacement and Abus...
...nts with low testosterone levels, we s...
...patients with low HDL (...
...r-Affirming Hormone Therapy...
...2.1 In transwomen and transmen who hav...
Table 4. Statins: LDL-C Reduction by Dose, and Major Drug Interactions
...ins: LDL-C Reduction by Dose, and Major Dru...
Table 5. Medications for Additional LDL-C Reduction in Patients Taking Statins (maximal tolerated doses)
...5. Medications for Additional LDL-C...