Dyslipidaemia
Abnormal blood lipid levels including elevated LDL cholesterol, triglycerides, or reduced HDL cholesterol. Dyslipidaemia is a component of metabolic syndrome and a cardiovascular risk factor. GLP-1 receptor agonists can modestly improve lipid profiles, particularly triglycerides, as a secondary benefit of treatment.
Technical Context
Dyslipidaemia patterns in metabolic syndrome/T2D: elevated triglycerides (>150 mg/dL, due to hepatic VLDL overproduction driven by insulin resistance), low HDL-C (<40 mg/dL men, <50 mg/dL women, due to increased HDL catabolism), and small dense LDL particles (more atherogenic than large buoyant LDL, even when total LDL-C is near normal). GLP-1 RA effects on lipids: triglyceride reduction 10-20% (likely mediated through reduced hepatic VLDL production secondary to weight loss and improved insulin sensitivity), modest LDL-C reduction (0-5%), and modest HDL-C increase (1-3%). These lipid effects are secondary endpoints in metabolic peptide drug trials and contribute to the overall cardiovascular risk reduction observed in CVOTs. Tirzepatide Phase III data showed somewhat greater lipid improvements than selective GLP-1 RAs.