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Lipoprotein Phenotypic Profile

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Determination of lipoprotein profile is used to evaluate hyperlipidemia and to monitor the pathological distribution and concentration of serum lipoproteins.

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Electrophoresis of lipoproteins and their classification based on Frederickson criteria are used to control the lipoprotein phenotypic profile.

Type I. Hyperchromicronemia. This is a very rare situation. The patient's serum is very lipemic, and if left overnight in the refrigerator a zone of micromicrons is formed. There are two situations that can give a false positive to type I hyperlipoproteinemia. The first situation is dysglobulinemia in which a large proportion of lipids are bound to immunoglobulins (IgM). The second situation is the removal of lipids from the lipoproteins as is the case with certain drugs that function as lipid removal agents, the uptake of which can lead to misleading results. It is also important that the sample is taken after fasting (> 12 hours), because hypercholomronemia becomes severe after ingestion.

Type IIa. Hypercholesterolemia. In this situation, there is a high concentration of β-lipoprotein with normal pro-β-lipoprotein. Α-Lipoprotein is normal or sometimes slightly reduced. LDL-cholesterol should be greater than 160 mg / dL. This type of hyperlipoproteinemia is a relatively common disorder.

Type IIb. Hypercholesterolemia with elevated triglycerides. This type of hyperlipoproteinemia is quite common. In addition to the high concentration of β-lipoprotein, there is an increased concentration of pro-β-lipoprotein. There are no chylomicrons and the α-lipoprotein band is normal or slightly reduced.

Type III. Hypercholesterolemia with hypertriglyceridemia. Serum total cholesterol and triglyceride levels are about 1: 1. Usually there are no chylomicrons and the β-lipoprotein, found at a high concentration, forms a large band and has greater mobility than the usual β-lipoprotein. The zones of β-lipoprotein and pro-β-lipoprotein are not completely separated due to the increase in the concentration of abnormal intermediate density lipoproteins (which lack apolipoprotein E). This abnormal lipoprotein migrates between the β-lipoprotein and pro-β-lipoprotein bands. Α-Lipoprotein is usually reduced. The definitive diagnosis for type III hyperlipoproteinemia may require ApoE genotype control.

Type IV. Hypertriglyceridemia. Increased pro-β-lipoproteins with normal or low β-lipoprotein fraction are found. Sometimes the mobility of the beta-lipoprotein fraction is faster than normal. Α-Lipoprotein is usually reduced. There are no millennials. If the serum triglyceride concentration is 200-300 mg / dL, the term "mild hyperlipoproteinemia type IV" may be used.

Type V. Hyperlipidemia with chylomicronemia. Chylomicrons, β-lipoprotein and pro-β-lipoprotein are usually elevated. Sometimes the concentration of serum triglycerides can be greater than 10,000 mg / dL. The total serum cholesterol concentration may also be elevated.




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