In a new Clinical Practice Guideline, researchers suggest that all adults with endocrine disorders should be tested for high cholesterol and triglycerides to evaluate their risk of heart attack or stroke.
This guideline provides an approach to assessing and treating high cholesterol and triglycerides in patients with endocrine diseases like hypothyroidism, menopause and Cushing’s syndrome.
The guideline was issued by the Endocrine Society.
The endocrine system includes eight major glands throughout your body, such as the thyroid gland, pituitary gland, adrenal gland, and pancreas.
This system affects growth and development, metabolism, sexual function, and mood.
If hormone levels are too high or too low, people may have an endocrine disease or disorder. Endocrine diseases and disorders also occur if the body does not respond to hormones the way it is supposed to.
Apart from diabetes, many endocrine diseases are not mentioned in cholesterol management guidelines.
This new guideline addresses this gap in information and has three main objectives: describe lipid abnormalities and cardiovascular risk in patients with endocrine diseases; assess whether treatment of the underlying endocrine disorder improves the lipid profile and/or lowers the risk of heart disease; and discuss the evidence for using cholesterol and triglyceride lowering medications, in addition to diet and exercise, in patients with these endocrine diseases.
Recommendations from the guideline include:
Obtain a lipid panel and evaluate cardiovascular risk factors in adults with endocrine disorders.
Start statins earlier in patients with type 2 diabetes and risk factors for cardiovascular disease.
Consider statin therapy at a younger age in adults with type 1 diabetes who have obesity, or vascular complications, or 20-year history of diabetes.
Rule out hypothyroidism before treatment with lipid-lowering medications. In patients with hypothyroidism, re-evaluate the lipid profile when the patient has thyroid hormone levels in the normal range.
Monitor the lipid profile in adults with Cushing’s syndrome and consider statin therapy in addition to lifestyle modifications if Cushing’s syndrome persists after treatment.
To treat high cholesterol or triglycerides in post-menopausal women, use statins rather than hormone therapy.
Evaluate and treat lipids and other cardiovascular risk factors in women who enter menopause early (before the age of 40-45 years).
One author of the study is Connie Newman, M.D.
The study is published in The Journal of Clinical Endocrinology & Metabolism (JCEM).
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