7 doctors weighed in:
Why doesn't everyone with familial hypercholesterolemia have fatty liver?
7 doctors weighed in

Dr. Bradley Radwaner
Internal Medicine - Cardiology
3 doctors agree
In brief: Most Do
Familial hypercholesterolemia is the most common genetic disorder involving choleterol levels .
If a patient has an LDL cholesterol level above 200 he/she has familial hypercholesterolemia. It is transmitted in a way that each child has a 50/50 chance of inheriting this. On a microscopic level there is increased liver fat in all of these patients, it just may not show up on blood tests.

In brief: Most Do
Familial hypercholesterolemia is the most common genetic disorder involving choleterol levels .
If a patient has an LDL cholesterol level above 200 he/she has familial hypercholesterolemia. It is transmitted in a way that each child has a 50/50 chance of inheriting this. On a microscopic level there is increased liver fat in all of these patients, it just may not show up on blood tests.
Dr. Bradley Radwaner
Dr. Bradley Radwaner
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1 comment
Dr. Zahid Ahmad
Is there any data to confirm microscopic fat in familial hypercholesterolemia ?
Dr. Zahid Ahmad
Internal Medicine - Endocrinology
1 doctor agrees
In brief: Cholesterol not fat
Cholesterol and fat are two different things.
Fat is transported in the human body as triglycerides, and it's triglycerides that accumulate in the liver in fatty liver. Patients with familial hypercholesterolemia don't typically have problems with triglycerides, but just like everyone else they can have such problems (especially if they gain allot of weight).

In brief: Cholesterol not fat
Cholesterol and fat are two different things.
Fat is transported in the human body as triglycerides, and it's triglycerides that accumulate in the liver in fatty liver. Patients with familial hypercholesterolemia don't typically have problems with triglycerides, but just like everyone else they can have such problems (especially if they gain allot of weight).
Dr. Zahid Ahmad
Dr. Zahid Ahmad
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Dr. William Cromwell
Clinical Lipidology
In brief: Normal VLDL function
Fatty liver due to disorders of lipid metabolism occur because fat (primarily triglyceride) synthesized in the liver is unable to be exported in vldl particles.
This is often present in familial combined hyperlipidemia (fch), Insulin resistance, and type ii diabetes mellitus. Familial hypercholesterolemia (fh), poor clearance of LDL but normal vldl metabolism, often does not produce a fatty liver.

In brief: Normal VLDL function
Fatty liver due to disorders of lipid metabolism occur because fat (primarily triglyceride) synthesized in the liver is unable to be exported in vldl particles.
This is often present in familial combined hyperlipidemia (fch), Insulin resistance, and type ii diabetes mellitus. Familial hypercholesterolemia (fh), poor clearance of LDL but normal vldl metabolism, often does not produce a fatty liver.
Dr. William Cromwell
Dr. William Cromwell
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