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Volume 11, Issue 2 (9-2021)                   cmja 2021, 11(2): 128-139 | Back to browse issues page


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Niknafs A, Rezvanfar M R, Salehi M. Hyperlipidemia and the Role of Blood Lipids According to Iranian Traditional Medicine. cmja 2021; 11 (2) :128-139
URL: http://cmja.arakmu.ac.ir/article-1-806-en.html
1- Department of Traditional Medicine, Traditional and Complementary Medicine Research Center (TCMRC), School of Medicine, Arak University of Medical Sciences, Arak, Iran.
2- Departement of Internal Medicine, Endocrinology and Metabolism Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
3- Department of Traditional Medicine, Traditional and Complementary Medicine Research Center (TCMRC), School of Medicine, Arak University of Medical Sciences, Arak, Iran. , salehi58@gmail.com
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1. Introduction

Hyperlipidemia is a condition that refers to an increase in blood fats. A large part of the causes of mortality and physical disability in most countries are cardiovascular complications caused by atherosclerosis which imposes high economic losses on countries. Elevated levels of cholesterol, chylomicrons, Low Density Lipoprotein (LDL) molecular weight and apolipoprotein B have been shown to be risk factors for cardiovascular diseases, such as atherosclerosis, coronary heart disease, ischemic stroke and chronic kidney disease. About half of heart attacks and a quarter of strokes are associated with elevated serum LDL and cholesterol levels. Statins are the first line drugs for the treatment or prevention of hyperlipidemia, and most patients have to take statins for a long period. However, statins and other anti-hyperlipidemic compounds alone do not have successful therapeutic effects, and control of blood lipids by using more than one drug or treatment method is more successful (Combined therapy). Numerous studies have shown the positive effects of concomitant use of dietary regime, physical activity, and herbal and natural remedies in the control of hyperlipidemia. Due to the growing tendency of the international community to use complementary medicine, familiarity with the views of Iranian traditional medicine (ITM) in this field can be effective in controlling hyperlipidemia and its problems.

2. Materials and Methods

This review study was conducted using a library method. First recent materials and findings related to blood lipids through were collected searching in reputable medical books and online databases such as Pubmed, Scopus, Web of science, SID, Magiran using the keywords Hyperlipidemia, Dyslipidemia, Cholesterol, Triglyceride, Atherosclerosis, Metabolic syndrome, and Statin. Then, by reviewing ITM books such as Qanon, Kamel Al-Sana’ah, Igraz Al-tabiah, Khulasah al-Hikmah, Makhzan Al-adviah, Mofarrah Al-gholub, Ghanonche, and Tebbe Akbari using the keywords Shahm, Pieh, Charbi, Balgham, Dosumat, dihn, and Samin using the Noor Software. Relevant materials were collected and then analyzed using the content analysis method.

3. Results

Fats are present in the blood as lipoprotein particles. They are mainly absorbed through food or made by the liver. Fats are substances for energy production and cellular metabolism in the body. In addition, they play a structural role in cellular membranes and the structure of many metabolic compounds in the body, such as hormones. It helps maintain body heat such as insulation, absorb and use fat-soluble vitamins, store energy, maintain homeostasis inside and outside cells, eliminate certain substances from the body and reduce the destructive effects of free radicals formed by the body’s metabolism or environmental factors. According to the principles of ITM, the human body needs food to survive. Food that is eaten and enters the stomach, under the influence of various digestive processes, is converted into four humors of blood, yellow bile, black bile, and phlegm. Each of these humors has its own properties and is responsible for actions. Maintaining health in the body requires the production of competent substances in terms of quality and quantity and in balanced proportions. The transformation of the eaten food into the essence of the organ takes place gradually through four stages of change (Estehale), which are called quadruple digestion including gastric digestion, hepatic digestion, intravascular digestion and intracellular digestion. Each digestion has some useful and necessary substances as well as some wastes that must be disposed of through specific ways. The formation of different organs and tissues of the body is done through humors and changes that take place on them. The general mizaj (temperament) of each organ is determined by which humor is more involved in its structure. Accordingly, in ITM books, the temperament of different parts of the body has been compared in terms of coldness, warmness, wetness and dryness.
In the book of Law (Qanon), Bu Ali Sina has interestingly compared the accumulation of fats in different parts of the body using a nature-oriented attitude with the process of snow formation. As the moisture in the air solidifies due to cold, it forms snow and ice crystals. Moistures from the body, which are in fact a group of humors, are converted into fat masses by organ coagulation and solidification due to cold. As we see more snowfall at different times of the year or in different parts of the earth due to the cold weather, substances that cause excess cold or wetness in areas of the body are expected to be related to increased fat. For example, one of the causes of abdominal obesity or accumulation of subcutaneous fat in the abdomen, from the perspective of ITM, is constipation or coldness in the intestines.

4. Conclusion

Hyperlipidemia is a broad concept; in addition to cardiovascular complications, it affects other parts of the body. Therefore, it should be examined from different aspects. Hyperlipidemia is mainly caused by an increase in fat absorption, failure to follow healthy eating patterns, consequent increased production of lipoproteins in the liver, decreased lipolysis, and consumption by tissues. As one of the components of metabolic syndrome, hyperlipidemia can be associated with a range of diseases such as obesity, hypertension, hyperglycemia, hyperuricemia, hyperinsulinemia, and fatty liver.
According to ITM, one of the effective factors in physical health is the balance between the humors. The humors are mainly formed in the liver and flow inside the arteries. Therefore, it can be said that all substances in blood vessels such as proteins, fats, carbohydrates, vitamins and minerals are a type of humors. If any humor is disturbed quantitatively or qualitatively, it is considered as an abnormal humor. The liver, as the main site of humors in the body, plays a key role in the development of hyperlipidemia and works very closely with the stomach. The heart, as a main organ, has its own intracellular digestion. The heart with a warm and dry temperament is located on the left side of the chest and the upper half of the trunk. The liver is located in the right side of body, in the abdominal area and below the heart with a warm and wet temperament. These two organs provide heat around the stomach and blood vessels inside the abdomen, which plays an important role in the digestion of food and nutrients. The heart and the liver are different in terms of warmness, coldness, wetness and dryness. The liver can try to compensate for the dryness created in organs such as the heart and brain by increasing the production of humors. In some cases, we see this compensation as a type of hyperlipidemia. All conditions and diseases that can affect the stomach, liver and heart and, thus, quadruple digestion can be effective in causing hyperlipidemia.

Ethical Considerations

Compliance with ethical guidelines

All ethical principles are considered in this article.

Funding

This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions

Research, resources, drafting, visualization: Alireza Nikonfs; Analysis, monitoring, validation: Mohammad Reza Rezvanfar; Methodology, conceptualization, editing, and finalization of writing and project management: Mehdi Salehi.

Conflicts of interest

The authors declared no conflict of interest.

Acknowledgements

We would like to thank Ms. Nastaran Nikonfs for her help.

 

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Type of Study: Review Paper | Subject: Traditional medicine

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