Lipid Info Charts

Chylomicron percentages/density

1. TG = 86%

2. Cholesterol = 5%

3. Phospholipid = 7%

4. Protein = 1%

5. Density = 0.95

VLDL percentage/density

1. TG = 55%

2. Cholesterol = 19%

3. Phospholipid = 18%

4. Protein = 8%

5. Density = 1

IDL percentage/density

1. TG = 23%

2. Cholesterol = 38%

3. Phospholipid = 19%

4. Protein = 15%

5. Density = 1.02

LDL percentage/density

1. TG = 6%

2. Cholesterol = 50%

3. Phospholipid = 22%

4. Protein = 22%

5. Density = 1.04

HDL percentage/density

1. TG = 5%

2. Cholesterol = 22%

3. Phospholipid = 33%

4. Protein = 40%

5. Density = 1.10

Chylomicron has what lipoproteins

• Apo-A1

• Apo-AIV

• Apo-B48

• Apo-C-!,!!,!!!

• Apo-E

VLDL has what lipoproteins

Apo-B-100

Apo-C-I,II,III

Apo-E

IDL has what lipoproteins

Apo-B-100

Apo-E

LDL has what lipoprotein

Apo-B-100

HDL has what lipoproteins

Apo-A-I,II,IV

Apo-C-I,II,II

Apo-E

Gaucher’s Disease: Enzyme deficiency

Beta glucocerebrosidase

Gaucher’s Disease: symptoms

• Thrombocytopenia

• Leukopenia

• Hepatosplenomegaly

Gaucher’s Disease: lab findings

• Gaucher cells

• Increased Acid phosphatase

• Glucocerebroside buildup

Niemann-Pick disease: Enzyme deficiency

Sphingomyelinase

Niemann-Pick disease: symptoms

• Psychometer

• intellectual deterioration

Niemann-Pick disease: lab findings

• overstuffed histocytes/ macrophages

• Sphingomyelin buildup

Tay-Sachs Disease: Enzyme deficiency

hexosaminidase- A

Tay-Sachs Disease: symptoms

• charry red spot in retina

• dementia

• psychometer deterioration

Tay-Sachs Disease: lab findings

ganglioside in CNS neurons

Steps for Atherosclerosis (ADD TO)

1. Inflammation

2. Fatty streak

3. Fibrous plaque

4. complicated lesion

Total Cholesterol Values

• Desirable = Less then 200

• Borderline high = 200-239

• Very high = greater than 240

HDL Cholesterol Values

• Desirable = greater then 60

• Low = less than 40

LDL Cholesterol Values

• Desirable = less than 100

• Near/above normal = 100-129

• Borderline high = 139-159

• high = 160-189

• Very high = greater than 190

TG Values

• Desirable = less than 150

• Borderline high = 150-199

• High = 200-499

• Very high = greater than 500

Total Cholesterol testing: Historical method

Liebermann-Birchard (L-B)

• cholesterol extracted and reacted with acids to form a colored product

• acids used: Sulfuric acid and Acetic anhydride acid

Total Cholesterol testing: Reference method

Abell

• cholesterol ester chemically hydrolyzed to make mixture entirely “free” cholesterol then measured via L-B

Total Cholesterol testing: Current method

Enzymatic endpoint method

• uses three enzymes

  • Cholesterol esterase

  • Cholesterol oxidase

  • Peroxidase

HDL Cholesterol Measurements: Historic selective precipitation method

1. Heparin-manganese-chloride or magnesium dextran sulfate is used to precipitate less dense Apo-B containing lipoproteins

2. Centrifuge to separate precipitate from supernatant

3. Test Supernatant that contains only HDL

HDL Cholesterol Measurements: Direct method

• Use a reagent that “shields” the enzyme from reacting with LDL and LVDL

• Eg-alpha-cyclodextrin

• Enzyme only “sees” HDL

TG measurement: Enzymatic method

• TG Lipase to produce glycerol

• glycerol kinase to produce glycerol-3-phosphate

• Various Rx with G3P producing measurable colored product

TG measurement: Visual

Clear = TG <150 mg/dL

Hazy to Turbid = 200-499 mg/dL

Opaque to milky = >500 mg/dL

Type 1- Familial Hyperchylomironemia

• High chlyomicron

• Creamy layer over clear plasma

• TG lvls usually > 1000 mg/dL

• VLDL slightly increase

• Signs/symptoms

  • LDL and C-II deficiencies

  • Xanthomas

  • Abdominal pain

  • Acute pancreatitis

Type 2a- Familial Hypercholesterolemia

• High LDL

• Clear plasma (can’t “see” cholesterol) ; might have a slight orange tint

• Increase LDL ~1200 mg/dL

• Signs/symptoms

  • defective B-100

  • atherosclerotic cardiovascular disease

  • Xanthomas

Type 2b- Familial combined hyperlipidemia

• High LDL and VLDL

• Increased Cholesterol, LDL, VLDL and TG

• Slightly turbid

• signs/symptoms

  • premature coronary artery disease

Type 3- Familial Dysbetalipoproteinemia

• High LDL, IDL, and VLDL (one band)

• Increased total cholesterol and TG

• slightly cloudy to cloudy

• signs/symptoms

  • Remnant removal disease (premature atherosclerosis)

  • CAD

  • Palmer xanthomas (yellow fat deposits on palms)

Type 4- Familial Hypertriglyceridemia

• High VLDLD

• Increase VLDL and TG

• decrease HDL-C

• normal cholesterol

• slightly cloudy, cloudy or opaque

• signs/symptoms

  • insulin resistance

  • obesity

  • acute pancreatitis

Type 5- Mixed hyperlipidemia

• High Chylomicrons and VLDL

• Extremely increased TG due to increased VLDL and Chylomicron

• Cholesterol slightly increased

• LDL and HDL normal

• opaque with floating creamy layer

• signs/symptoms

  • Acute pancreatitis

  • Eruptive xanthomas

  • abnormal glucose tolerance