HYPERCHOLESTEROLEMIA

1. HYPERCHOLESTEROLEMIA TG HAJAR ASYIQIN BINTI TENGKU IBRAHIM D11A036 NURUL SYUHADA BINTI RIBUAN D11A032 HERLINA BINTI MOHD RAPI D11A010 NIK NUR AFINA BINTI NIK ALWI D11A021

2. WHAT IS HYPERCHOLESTEROLEMIA?

3. What is Hypercholesterolemia • the presence of high levels of cholesterol in cells and plasma of the circulating blood. • It is a form of hyperlipidemia(elevated levels of lipids in the blood and hyperlipoproteinemia(elevated levels of lipoproteins in the blood).

4. What animal involve? • Commonly occurs at lactating cow.( Saunders)

5. It also can be occur in dog.

6. THE CAUSES OF HYPERCHOLESTROLEMIA DIET GENETICS

7. cause of hypercholesterolemia • Your diet. - You can decrease your risk of high cholesterol by reducing the amount of saturated fat andcholesterol in fat that you eat. • Your age and sex. -The risk of high cholesterol increases with age for both men and women. Men are at higher risk than women, but after menopause, women start to catch up to men. • Not enough physical activity. -You can decrease this high-cholesterol risk by getting some exercise for at least 30 minutes most days of the week. • Being overweight. -Dropping some pounds and maintaining a healthy weight can help decrease this risk factor for high cholesterol.

8. High Cholesterol Diet • Trans fatty acids food - Fast food, canned soups, frozen meals and various pudding and peanut butter • Saturated Fat Food • Animal-derived foods -  Plant-derived sources

9. Healthy diet • Cut down on saturated fats and trans fats. >10% of your daily calories should come from saturated fat. • Avoid trans fats completely. 2% increase in energy intake from trans fats increases the heart disease by 23%. Choose unsaturated fats, such as olive oil and canola oil, instead.

10. Eat fatty fish. The American Heart Association recommends people eat at least twice of fatty fish per week.

11. Eat phytosterols and stanols found in nuts, seeds, vegetable oils, and fortified food products, such as orange juice, yogurt, margarine spreads, and salad dressing. Studies show that eating spreads enriched with phytosterols per day reduced total cholesterol by up to 11% and LDL cholesterol by up to 15%.

12. Eat whole grains - whole wheat bread and pasta, oatmeal, oat bran, and brown rice. • Eat more fruits and vegetables, which are high in fiber and can help lower cholesterol levels. Studies show that plant based diets are associated with decreases in total cholesterol and LDL cholesterol of up to 15%.Limit cholesterol in diet. The highest amounts are found in egg yolks, whole milk products, and organ meats.

13. Lowering your cholesterol may involve more than diet alone. To get the most benefits, pair your healthy diet with 30 to 60 minutes of daily exercise and toss out your cigarettes if you smoke. • You may also end up needing to take a cholesterol-lowering pill for more rapid results but that doesn't exempt you from making healthier lifestyle choices.

14. HOW GENETICS CAN CAUSE HYPERCHOLESTEROLEMIA?

15. GENETICS CAUSES OF FAMILIAL HYPERCHOLESTEROLAEMIA • Familial hypercholesterolemia (FH) is an inherited disorder due to high concentration of serum LDL cholesterol. • FH are the result from defects in the hepatic uptake and degradation of LDL via the LDL-receptor pathway. • It commonly caused by a loss-of –function mutation in : • LDL-receptor gene (LDLR) • APOB • LDLRAP1, • PCSK9

16. LDL-receptor gene The LDLR gene provides instructions for making a protein called a low-density lipoprotein receptor. This type of receptor binds to particles called low-density lipoproteins (LDLs), which are the primary carriers of cholesterol in the blood. The receptor needed to remove low-density lipoproteins from the bloodstream,

17. number of low-density lipoprotein receptors produced within cells are reduced. High level of blood cholesterol LDLR Mutation cholesterol deposited abnormally in tissues such as the skin, tendons, and arteries HYPERCHOLESTROLEMIA

19. APOB Five mutations in the APOB gene are known to cause a hypercholesterolemia called familial defective apolipoprotein B-100 (FDB). Each of these mutations changes a single protein building block (amino acid) in a critical region of apolipoprotein B-100.

20. a single protein building block (amino acid) in a critical region of apolipoprotein B-100 are changed prevents LDL from effectively binding to their receptors on the surface of cells ABOP mutation excess cholesterol circulates through the bloodstream, it is deposited abnormally in tissues and cause HYPERCHOLESRTROLEMIA cholesterol levels are much higher than normal fewer LDLare removed from the blood

21. LDLRAP1 More than 10 mutations in the LDLRAP1 gene have been shown to cause a form of inherited high cholesterol called autosomal recessive hypercholesterolemia.

22. low-density lipoprotein receptors are unable to LDL from the bloodstream effectively abnormally small, non-functional of LDLRAP1 protein or prevent cells from making any of this protein LDLRAP1 gene mutation excess cholesterol circulates through the bloodstream, it is deposited abnormally in tissues and may cause HYPERCHOLESTROLEMIA extra low-density lipoproteins remain in the blood extra LDL remain in the blood.

23. PCSK9 • several PCSK9 mutations can cause an inherited form of high cholesterol (hypercholesterolemia). • These mutations change a single protein building block (amino acid) in the PCSK9 protein. • Researchers describe the mutations responsible for hypercholesterolemia as "gain-of-function" because they appear to enhance the activity of the PCSK9 protein or give the protein a new, atypical function.

24. Researchers speculate that the altered protein may cause these receptors to be broken down more quickly than usual. • With fewer receptors to remove low-density lipoproteins from the blood, the body with gain-of-function mutations in the PCSK9 gene have very high blood cholesterol levels. • As the excess cholesterol circulates through the bloodstream, it is deposited abnormally in tissues and cause HYPERCHOLESTROLEMIA

25. Signs of Hypercholesterolemia

26. SIGNS • Lack of appetite, vomiting, diarrhea, abdominal discomfort • Acute pancreatitis, which can cause all the above signs plus severe abdominal pain • Skin problems, such as hair loss or itching • Central nervous system signs, such as seizures • Inflammation inside one or both eyes that produces a cloudy appearance • cholesterol deposition in tissues, e.g. corneal deposits

27. TREATMENT?

28. TREATMENT • Control diet ; give less fat diet • Fish oil supplement • Regular monitoring • Drugs: Should be considered ONLY if dietary therapy, above, is not producing the desired results. The drug are bile acid sequestrantsand the HMG-Co-A reductaseinhibitors • Treat all secondary problems resulting from acute or chronic disease (e.g. diabetes, seizures)

29. hereditary hypercholesterolemia can be difficult to treat and also should not be used for breeding. • Most medications that are used in people, such as the statin drugs (Lipitor, Pravachol, Zocor, etc.) are not used in animals because of their tendency to cause cataracts and other side effects.