Atherogenic Dyslipidemia

Many practitioners have long appreciated that a significant proportion of patients with coronary artery disease do not have marked LDL cholesterol elevations. Instead, they have several risk factors which include mild LDL and triglyceride elevations, moderate HDL reductions, central obesity, mild hypertension and insulin resistance. This constellation has been called clustered risk factors, Reaven’s syndrome, the deadly quartet, syndrome X, metabolic syndrome, and insulin resistance syndrome.

In an effort to draw attention to the lipid profile characteristic of this common syndrome, Scott Grundy, a leading lipidologist, coined the term “Atherogenic Dyslipidemia” (ADL).  

The parameters for ADL are as follows:

• LDL-cholesterol  >130 mg/dL
• Triglycerides  >150 mg/dL
• HDL-cholesterol < 40 mg/dL for men & < 50 mg/dL for women

Patients with this profile are very likely to have small, dense LDL particles and increased levels of apolipoprotein B-100. The prevalence of the complete syndrome (all three abnormalities appearing in the same individual) is estimated to be 25-30 percent of the adult population. This prevalence is equal to the percent of adults with isolated hypercholesterolemia.

Reference

Grundy SM. Atherogenic dyslipidemia associated with metabolic syndrome and insulin resistance. Clin Cornerstone. 2006;8 Suppl 1:S21-7. doi: 10.1016/s1098-3597(06)80005-0. PMID: 16903166.