HIPERLIPROTEINEMIJE-TERAPIJA I OSVRT NA SPORTSKU POPULACIJU- DEO1.
Valentina Štulić
Udruženje za medicinu sporta Srbije

Opšte je prihvaćeno mišljenje da su hiperlipoproteinemije jedan od najvažnijih faktora rizika za nastanak ateroskleroze i oboljenja srca. Opšta usaglašenost o korisnom efektu smanjivanja holesterola dovela je do pojave nacionalnih edukacionih programa za holesterol i druge lipide. Zabrinjavajući je podatak da je učestalost ovih poremećaja u dečjem uzrastu do 10%, kao i da se dislipidemije pojavljuju i u sportskoj populaciji.
Lipidi su u organizmu važan izvor energije, ali i deo strukturnih elemenata ćelija. Osnovne frakcije lipida u krvi su holesterol, trigliceridi, fosfolipidi i masne kiseline.
U plazmi postoji više vrsta lipoproteina-VLDL, LDL, VHDL, HDL, IDL.
Laboratorijski skrining lipidnih poremećaja treba započeti u adolescentnom periodu.
Određuju se ukuni holesterol, trigliceridi, LDL i HDL holesterol.
Postoje više tipova lipidnih poremećaja, a pre svega mogu biti primarni i sekundarni. Sama terapija se usklađuje prema tipu poremećaja. Prema NCEP III LDL uočen kao glavni faktor rizika za IBS i prema tome glavni cilj terapije.
U poslednjih deset godina plasiran je agresivniji pristup u terapiji HLP i za primarnu i za sekundarnu prevenciju. Kod sportista terapija statinima nosi sa sobom povećan rizik od pojave miopatija.

Ključne reči: hiperlipoproteinemije, terapija hiperlipoproteinemija

LIPID DISORDERS-TREATMENT AND AN OVERVIEW TO SPORT POPULATION- PART 1.
Valentina Stulic

Sports Medicine Association of Serbia

It is well known that lipid disorders are determined and blamed as main risk factor for beggining and development of atherosclerosis. National Cholesterol Education Program adult treatement III are presented as a pointed guidelines for treatment and better aproach to this disorders. Concerning issue is the fact that lipid disorders are not rare even in childhood and adolescence with frequency of nearly 10% and also the fact that lipid disorders can be present and evaluate even in sport population.
Lipids are in fact mainly fuel for metabolic reactions and also the part of cellular structures. Basic fractions of lipids in blood are cholesterol, triglycerides, phospholipides and fatty acids. There are different types of lipoproteins VLDL, LDL, HDL, VHDL, IDL:
Screening for lipid disorders has to start early in adolescent period. In practice that means determine the level of total cholesterol, triglycerids , LDL and HDL fraction of cholesterol. Lipid disorders are clasiffied into different types, but all are divided in primary and secundary disorders. The therapy of this disorders are modified regarding the type of hyperlipidemia. The main aproach of NCEPIII guidelines is the conecpt of LDL as target or in charge for risk of development CVD
In past ten years it has been accepted the agressive aproach in treatement of lipid disorders. The menagement of dislipidemias among athletes is presented as a challenge and NCEPIII panel tailored to individual athlete and points out the special cautions in the use of statins in athletes.

Key words: hipercholesterolemia, terapy of hipercholesterolemia

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