Understanding the Essentials of Blood Lipid Metabolism

Kori J. Kingsbury, RN, MSN, Greg Bondy, MD, FRCPC

In This Article

Abstract and Introduction

The authors present an introduction to the basics of lipid metabolism including an overview of the structure and function of lipoproteins and a description of the pathways of lipid metabolism. Dyslipidemia is an important risk factor in the context of cardiovascular disease, and appropriate intervention can have a significant impact on clinical outcomes. The information presented herein will help to provide a foundation of knowledge on which to base the assessment and treatment of dyslipidemic patients. A better understanding of lipid metabolism will help health care professionals to provide better care in the realm of dyslipidemia management.

Cardiovascular disease, including coronary heart disease and stroke, is the leading cause of death in developed nations.[1] There is substantial evidence documenting the relationship between cardiovascular disease and increased serum cholesterol levels.[2] Intervention studies have identified the benefits of cholesterol-lowering therapy in the context of primary and secondary prevention of cardiovascular disease; thus, the assessment and treatment of dyslipidemic patients is a prominent component of cardiovascular care.[3,4] Although guidelines are available to assist in clinical decision-making, it is often challenging for the novice practitioner to locate simple, straightforward information on lipid metabolism, particularly for the clinician who may not have an extensive science background.[5,6] As cardiovascular nurses and other health care professionals strive to ensure optimal care for dyslipidemic patients, it is imperative to understand the basics of lipid metabolism to better comprehend clinical management strategies.

The intentions of this paper are not to present an exhaustive review of lipid metabolism, but rather to provide an introduction to this robust topic, enabling the novice practitioner to have a greater appreciation for the science on which to base his or her practice. A brief explanation of some of the terminology used in this field is presented, as well as a description of the function of serum lipids and lipoprotein classifications. Overviews of apolipoproteins and lipid processing enzymes are also described. The pathways of lipoprotein transport, depicting the ways that lipoproteins are processed and removed from the plasma, are presented to promote an understanding of the pathophysiologic basis for dyslipidemic conditions.