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Hypercholesterolemia, Atherosclerosis, Fatty Liver and Obesity

An elevated blood cholesterol level is called hypercholesterolemia. Throughout the body, cholesterol is found in all cells as a waxy substance.


An elevated blood cholesterol level is called hypercholesterolemia. Throughout the body, cholesterol is found in all cells as a waxy substance. Typical sources of cholesterol are meat, poultry, dairy products, eggs and fish. However, cholesterol can also be found in certain foods like meat, poultry, dairy products and eggs. Foods rich in saturated fats and trans fats cause the liver to make an excess of cholesterol, which can result in hypercholesterolemia in some cases. There are various functions of cholesterol in the human body, including the synthesis of cell membranes, some hormones, and substances needed for fat digestion. An excessive level of cholesterol, however, can lead to coronary artery disease.


In the coronary arteries, which carry blood to the heart, fatty deposits are formed from excess cholesterol in the blood. Atherosclerotic plaques form when cholesterol accumulates, narrowing and hardening artery walls. Atherosclerosis is associated with this. If these plaques become large enough, they can block the vessels and make it difficult for oxygen-rich blood to reach the heart. Heart attacks and angina become more prevalent due to this. The carotid artery (artery supplying blood flow to the brain) narrows and hardens over time, and a person is more likely to suffer a stroke. Hypercholesterolemia can also occur in inheritable forms, affecting the underside of the eyelids as well as the tendons. Among the most common forms of hypercholesterolemia is familial hypercholesterolemia. The cause of high cholesterol levels is often a high-fat diet and a lack of physical activity, even if the condition is inherited. The disease is therefore often preventable by following a healthy lifestyle, such as exercising regularly and eating a low-fat diet. Cholesterol-lowering medications may be recommended if diet and exercise are not sufficient to lower levels. Liposomal-forming substances circulate in the blood and contain both cholesterol and proteins. Lipoproteins are divided into different types based on the amount of cholesterol. Various parts of the body receive cholesterol from low density lipoprotein (LDL), which is found in the liver. As a result of too much LDL cholesterol, atherosclerosis can develop in arteries. The bad cholesterol is often called LDL.

However, HDL transports fat deposits to the liver, where they are broken down and thrown away. "Good cholesterol" is what is known as this lipoprotein. Physical inactivity, diets that are high in fat, and obesity contribute to high LDL levels and low HDL levels due to unhealthy lifestyle choices. Smokers, people with diabetes, high blood pressure, and those with a family history of heart disease and stroke are also at risk.


The main cause of atherosclerosis is cholesterol plaques lining the arteries that harden and narrow with time. The narrowing of your arteries can make blood flow more difficult. Arteriosclerosis is also called atherosclerosis or atherogenic cardiovascular disease. In most cases, high blood pressure results in cardiovascular diseases, such as heart attacks and strokes.

Throughout your body, blood is carried by arteries, which originate in your heart. An endothelium lining lines the inside of their walls. This keeps your arteries smooth and in good shape, allowing blood to flow freely. Endothelium damage leads to atherosclerosis. It is commonly caused by:
  • Smoking
  • Diabetes and obesity
  • High blood pressure
  • Inflammation
  • High cholesterol
Plaque builds up along the artery walls as a result of that damage. The bad cholesterol, or LDL, enters the artery wall after crossing a damaged endothelium. White blood cells then start digesting the cholesterol. Your artery wall becomes plaque as cholesterol and cells build up over time. Plaques create bumps on your artery walls. That bump gets bigger as atherosclerosis advances. Eventually, it may lead to a blockage. Every part of your body participates in that process. It doesn't just affect your heart. You may also be at risk for strokes and other health issues. It is usually not symptomatic of atherosclerosis until you reach middle age or older. Blood flow can be impeded and pain can occur when the narrowing becomes severe. Blocked arteries may rupture suddenly. At the site of a rupture, blood clots inside the artery.

Fatty liver

The liver develops fatty liver when triglycerides and other fats build up inside the liver cells. As the liver's processes of delivery and removal are balanced, the amount of fatty acid in the liver will vary. Occasionally, fatty liver is associated with inflammation of the liver and liver cell death (steatohepatitis).

A fatty liver is also known as hepatic steatosis. The accumulation of liver fat causes fatty liver. It is normal for your liver to contain small amounts of fat, but too much fat can cause health problems. The liver plays an important role in your health as the second largest organ in your body. A liver's primary function is to process food and drink nutrients and remove harmful substances from the bloodstream. There is a risk that scarring and damage to the liver will result when the liver is inflamed due to too much fat in it. If the scarring becomes severe, it can lead to liver failure. When people who drink a lot of alcohol develop fatty liver, this is called alcohol-related fatty liver disease (AFLD). Those who do not drink much alcohol are susceptible to non-alcoholic fatty liver disease.

There are four stages of liver fatty tissue:

Simple fatty liver - An excess of fat has accumulated in the liver. Simple fatty livers are generally harmless as long as they don't progress.

Steatohepatitis - Furthermore, the liver is inflamed in addition to having excess fat.

Fibrosis - Scarring in the liver is now the result of persistent inflammation. In general, the liver is still capable of functioning normally.

Cirrhosis - Due to scarring, the liver can no longer perform its normal functions. Irreversible scarring of the liver has occurred.

Similar symptoms are present in both AFLD and NAFLD. Unfortunately, fatty livers often don't display any symptoms. It is possible to feel exhausted, or to have discomfort in the upper right part of your abdomen. Among the complications of fatty liver disease are liver scarring and liver cancer. Fibrosis is the term for liver scarring. As liver fibrosis progresses, it can increase your risk of cirrhosis, a potentially fatal condition. The liver is permanently damaged by cirrhosis. This is why preventing the disease from occurring is crucial.

Common symptoms include -
  • Nausea
  • Yellow skin
  • Itchiness
  • Pale stools
  • Abdominal pain
  • Confusion
  • Breast enlargement in men
  • Easy bruising as well as bleeding
  • Dark coloured urine


An excessive amount of body fat is the cause of obesity. The disease goes beyond appearance. It's a medical condition that increases the risk of other diseases and health problems, including high blood pressure, diabetes, heart disease, and certain types of cancer.

Fat accumulation that is abnormal or excessive may impair health, which is the definition of overweight and obesity. An individual's body mass index (BMI) determines whether they are overweight or obese by combining their weight and height. The weight/height ratio is equal to the square of a person's height in meters x the kilograms they weigh (kg/m2).

The following are the WHO definitions for overweight and obesity in adults:
  • BMI of 25 and above is considered overweight;
  • Obesity is defined as having a BMI greater than 30.
The BMI is the best indicator of overweight and obesity at the population level as it is the same for men and women of all ages. It should, however, be viewed as an approximate guide, since different individuals may not show the same level of fatness. Childhood overweight and obesity must be considered based on age.

If you have a child under the age of five:
  • A child considered overweight if their weight is over 2 standard deviations over WHO Child Growth Standards.
  • Weight-for-height of a child considered obese exceeds three standard deviations above the median, according to WHO Child Growth Standards.
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Ankur Choudhary is India's first professional pharmaceutical blogger, author and founder of pharmaguideline.com, a widely-read pharmaceutical blog since 2008. Sign-up for the free email updates for your daily dose of pharmaceutical tips.
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