Endo in a Bite

This episode reviews the management of dyslipidemia in special populations using an individualized, risk based framework. It emphasizes ASCVD risk assessment in older adults, patients receiving gender affirming hormone therapy, individuals living with HIV, those with chronic inflammatory or autoimmune diseases, adult survivors of childhood cancer, and solid organ transplant recipients. The discussion highlights statin selection, drug drug interactions, use of non statin therapies, and the limitations of traditional risk calculators, underscoring the importance of shared decision making and tailored lipid lowering strategies in populations with complex and often underestimated cardiovascular risk.

This episode reviews guideline directed statin therapy and LDL lowering strategies using ASCVD risk based statin benefit groups. It emphasizes selection of statin intensity, LDL C treatment targets, and appropriate escalation to non statin therapies, including ezetimibe, PCSK9 inhibitors, and bempedoic acid. The episode also addresses statin associated muscle symptoms, CK based management thresholds, and evidence based approaches to true statin intolerance with shared decision making for optimal cardiovascular risk reduction.

This episode reviews the management of hypertriglyceridemia in pregnancy using a triglyceride level guided framework. It emphasizes risk stratification for maternal ASCVD versus pancreatitis, identification of secondary and genetic dyslipidemias, and implementation of lifestyle, dietary, and pharmacologic interventions with multidisciplinary oversight throughout gestation and lactation.

This episode reviews the evaluation and management of adult hypertriglyceridemia using a triglyceride level driven framework. Emphasis is placed on risk stratification to distinguish ASCVD risk reduction from pancreatitis prevention, identification and treatment of secondary and genetic contributors, and implementation of evidence based lifestyle and dietary interventions to guide therapy.

This episode breaks down hypertriglyceridemia in adults, covering classification by level, etiology, particle type, and clinical risk orientation.

This episode reviews the evaluation of adults with severe hypertriglyceridemia, according to the 2025 AACE Algorithm.

• Severe Hypertriglyceridemia: Understand impaired triglyceride clearance, chylomicron accumulation, and increased pancreatitis risk, including multifactorial causes.

• Familial Chylomicronemia Syndrome: Recognize this rare, early onset disorder with persistent hypertriglyceridemia despite low fat intake.

• Dysbetalipoproteinemia (APOE E2/E2): Learn about equal elevations of TG and cholesterol, tuberous xanthomas, low Apo B, and excellent response to fibrates.

This episode reviews how to evaluate and manage adults with extremely low or extremely high HDL cholesterol according to the 2025 AACE Algorithm.

• Identifies secondary causes of abnormal HDL, such as renal disease, low estrogen states, hyperandrogenism, medications (fibrates, TZDs, niacin, anti epileptics), alcohol excess, estrogen therapy, or pesticide exposure.

• Explains key genetic disorders linked to HDL extremes, including ABCA1 (Tangier disease), LCAT (fish eye disease), APOA1 deficiency, CETP deficiency, SCARB1 deficiency, LIPC deficiency, LIPG deficiency, and APOC3 variants.

• Summarizes diagnostic clues and next steps, such as examination for corneal clouding, orange tonsils, xanthomas, neuropathy, kidney evaluation, fasting lipid profile confirmation, and targeted genetic or family screening.

This episode reviews how to evaluate and manage adults with very low LDL cholesterol (<40 mg/dL) according to the 2025 AACE Algorithm.

• Identifies secondary causes such as lipid lowering therapy, malnutrition, malabsorption, and chronic diseases.

• Explains key genetic disorders linked to low LDL. Including MTTP, APOB, PCSK9, ANGPTL3, and SAR1B mutations.

• Summarizes diagnostic clues and next steps, such as liver ultrasound, vitamin level assessment, and genetic or family screening.

This episode explores the next step in the 2025 AACE Dyslipidemia Management Algorithm, focusing on adults with LDL cholesterol levels of 190 mg/dL or higher.

• Discusses how to evaluate for Familial Hypercholesterolemia and rule out secondary causes.

• Reviews diagnostic tools such as the Dutch Lipid Clinic Network, Simon Broome, and Welsh criteria.

• Outlines a stepwise approach to assessment, genetic testing, and family screening for early prevention

This episode serves as the introduction to the series on the 2025 AACE Dyslipidemia Management Algorithm, focusing on patient centered risk assessment and lifestyle based prevention strategies.

• Covers ASCVD and pancreatitis risk evaluation, lifestyle modification, and shared decision making.

• Introduces ASCVD risk classification, validated risk calculators, and integrated cardiometabolic management.

• Highlights the importance of equity, medication access, and long term adherence.