Diet and lifestyle: high saturated or trans fat intake, excess calorie intake, obesity, and low physical activity commonly raise LDL-C or other apoB-containing particles.
Genetics: familial hypercholesterolemia and polygenic predisposition can cause persistent or markedly elevated LDL-C, often from a young age.
Metabolic and hormonal: hypothyroidism and cholestatic liver disease are classic secondary causes. Insulin resistance or poorly controlled diabetes more often causes high triglycerides, low HDL, and small dense LDL, with LDL-C sometimes modestly increased.
Less common: nephrotic syndrome and certain medications, including thiazide diuretics, retinoids, corticosteroids, and some immunosuppressants.
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