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FCH (familial combined hyperlipidaemia)

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This condition causes a variable increase in cholesterol (6.5-10 mmol/L) and triglycerides (2.3-12 mmol/L). It is the second commonest primary hyperlipidaemia (after polygenic hypercholesterolaemia).

Patients presenting with this condition are:

  • generally over 30 years of age
  • often overweight
  • often insulin resistance or diabetes mellitus
  • often hypertension
  • may have premature coronary heart disease
  • there may be different lipoprotein abnormalities in different generations
  • xanthelasma but tendon xanthomata do not occur. Often, corneal arcus is present

Previously this disorder was thought to have a dominant inheritance although now it appears that affected families have a type of polygenic hyperlipidaemia, resulting in variable phenotypes among family members.

This condition may be seen about 0.5 %-1% of the general population and in up to 15% of patients suffering myocardial infarctions who were less than 60 years old at the time of the myocardial infarction.

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