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. Hyperchylomicronemia. This is a very rare situation. The patient's serum is very lipemic, and if left overnight in the refrigerator a zone of chylomicrons is formed. Two situations 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 hyperchylomicronemia becomes severe after taking food.
Type IIa. Hypercholesterolemia. In this situation, there is a high concentration of beta-lipoprotein with normal pro-beta-lipoprotein. Αlpha-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 beta-lipoprotein, there is an increased concentration of pro-beta-lipoprotein. There are no chylomicrons and the alpha-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 beta-lipoprotein, found at a high concentration, forms a large band and has greater mobility than the usual beta-lipoprotein. The zones of beta-lipoprotein and pro-beta-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 beta-lipoprotein and pro-beta-lipoprotein bands. Alpha-lipoprotein is usually reduced. The definitive diagnosis for type III hyperlipoproteinemia may require ApoE genotype testing.
Type IV. Hypertriglyceridemia. Increased pro-beta-lipoproteins with normal or low beta-lipoprotein fractions are found. Sometimes the mobility of the beta-lipoprotein fraction is faster than normal. Alpha-lipoprotein is usually reduced. There are no chylomicrons. 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, beta-lipoprotein, and pro-beta-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.
Important Note
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.
