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Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, the risk of muscle damage exists. Nicotinic acid, like fibrates, is also well suited for lowering triglycerides by 20–50%. It may also lower LDL by 5–25% and increase HDL by 15–35%. Niacin may cause hyperglycemia and may also cause liver damage.
Rates of high total cholesterol in the United States in 2010 are just over 13%, down from 17% in 2000. [89] Average total cholesterol in the United Kingdom is 5.9 mmol/L, while in rural China and Japan, average total cholesterol is 4 mmol/L. [10] Rates of coronary artery disease are high in Great Britain, but low in rural China and Japan. [10]
A 2018 review found that ezetimibe used as sole treatment slightly lowered plasma levels of lipoprotein(a), but the effect was not large enough to be important. [22] Ezetimibe improves the non-alcoholic fatty liver disease activity score but the available evidence indicates it does not improve outcomes of hepatic steatosis. [23]
The most important adverse side effects are muscle problems, an increased risk of diabetes mellitus, and increased liver enzymes in the blood due to liver damage. [ 5 ] [ 65 ] Over 5 years of treatment statins result in 75 cases of diabetes, 7.5 cases of bleeding stroke , and 5 cases of muscle damage per 10,000 people treated. [ 34 ]
In familial hypercholesterolemia, a mutation in the LDLR, PCSK9, or APOB is usually the reason for this and these mutations result in high LDL cholesterol. [8] In combined hyperlipidemia, there is an overproduction of apoB-100 in the liver. [9] This causes high amounts of LDL and VLDL molecules to form. [9]
Conversely, “with too much testosterone, women often have acne, too much hair on the body, hair loss on the head, high blood pressure, elevated cholesterol, skipped cycles, or problems ...
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