[Disorders of lipid metabolism and insurance medicine practice]

The evaluation of lipometabolic disorders is presented within the framework of epidemiological and pathophysiological findings. Insurance medicine can base its risk assessment practices on the recommendations of American and European consensus conferences. The upper normal value for total cholesterol is in the vicinity of 200 mg/dl. The atherogenic risk of an elevated total cholesterol level can be further defined by determining the LDL and HDL cholesterol. The LDL cholesterol level should not exceed 160 mg/dl and the HDL level should not be lower than 35 mg/dl for men and 45 mg/dl for women. The quotients from the total/HDL cholesterol levels (normal value less than 6) and the LDL/HDL levels (normal value less than 4) can be used for differentiated risk assessment. Triglyceride levels exceeding 200 mg/dl are primarily to be taken into consideration as a risk indicator if there is a simultaneous reduction of HDL cholesterol. Additional parameters, such as nicotine abuse, hypertension, a family history of cardiovascular disease, impaired glucose tolerance, male sex, obesity and the existence of peripheral vascular disorders are also to be included in the risk profile. Determining additional lipometabolic substances is only of relevance to insurance medicine in individual cases.