2005 & 2010: Overlap between FCH, METS, T2DM, and Obesity

As Williams observed, FCH characteristics overlap with characteristics of diabetes and obesity more so than FH characteristics do. On the left, Cennaro et al depict an association of combined hyperlipidemia with, as the name suggests, familial combined hyperlipidemia, but also with type 2 diabetes and metabolic syndrome. As can be seen, higher TG levels often distinguish these others from FH. So a scoring system that de-emphasizes high TG levels or does not exclude those who have such will support an erroneous assumption that many with high cholesterol are “FH” even if their cholesterol levels are due to other causes. Also, FH problems show up in childhood more so than FCH problems do — for that reason, a scientist can remove a degree of risk of misdiagnosis when studying only children. On the right is a report about lipid disorders in childhood. A distinguishing feature between FH and the otherwise similar lipid profiles of FCH, METS, and obesity is high TG. Again, if we deliberately preclude or discourage genetic testing, and deliberately remove consideration for higher TG, we will decide for future students who the “FH’ patients are. If no one has an awareness of the historical record, having thus no hint of the missing information, then the new, re-written instructions support higher prevalence estimates and help increase drug sales.

FCH is associated with Metabolic Syndrome, Type 2 Diabetes, and obesity.