CC SPH EXAM 4 (LIpid Prof)

cholesterol

–evaluates the risk for atherosclerosis, myocardial and coronary arterial occlusions.

cholesterol

Direct relationship between elated serum cholesterol and myocardial infarction

Lecithin-cholesterol acyl transferace (LCAT)

–Catalyzes the esterification of cholesterol (HDL) by promoting the transfer of fatty acids from lecithin to cholesterol which results in the formation of lysolecithin and cholesterol ester.

Apo A1

activator of LCAT

lecithin-cholesterol acyltransferase

enables HDL to accumulate cholesterol as cholesterol ester.

colorimetry

quantification method one step

C + extraction (bloors)

quantification method two step

C + E + Saponification (abell-kendall)

quantification method three step

C + E + S + Precipitation

Quantification method four step

triglyceride

It evaluates suspected atherosclerosis and measures the body’s ability to metabolize fat.

>200 mg/dl

Fasting TAG ____ are at risk for coronary artery disease because of atherogenic VLDL remnants.

TAG and Cholesterol

are the most important lipids in the management of Coronary artery disease.

Modified Van Handel and Zilversmith

CDC reference method for Triglyceride

<150 mg/dl

normal reference value for TAG

150-199 mg/dL

borderline reference value for TAG

200-499 mg/dl

High TAG reference value

>500

very high TAG reference value

lipoproteins

–Are large macromolecular complexes of lipids with specialized proteins as apolipoproteins.

lipoproteins

Main purpose is to transport TAG and cholesterol to sites at energy storage and utilization.

apolipoproteins

Helps to keep the lipids in solution during circulation through the blood stream.

Apo A1

HDL apolipoproteins

Apo B100

Apolipoproteins for LD, VLDL

Apo B48

APO for Chylomicrons

chylomicrons, VLDL, HDL, LDL

what are major lipoproteins

Chylomicrons

•Largest and least dense.

•Produced in the intestine from dietary fat, completely cleared within 6-9 hours post prandial.

•Transports exogenous/dietary TAG to liver, muscles, fat tissues.

APO B48, Apo C, Apo E

apolipoproteins for chylomicrons

VLDL / pre-beta lipoproteins

•Transport endogenous TAG from the liver to muscle, fat depots and peripheral tissues.

•Prolonged consumption of high fat diet leads to elevated TAG in VLDL particles.

Apo B100, Apo C, Apo E

apolipoproteins for VLDL

HDL/ alpha lipoproteins

•Smallest but most dense

•Transports excess cholesterol from the tissue and return it to the liver (reverse cholesterol transport)

•HDL2 transport effectively the lipids to the liver and more cardioprotective

Apo AI, Apo AII, Apo C

apolipoproteins for HDL

LDL/ Beta lipoproteins

•Major end product from catabolism of VLDL

•Transport cholesterol to the peripheral tissues.

Apo B100, Apo E

apolipoproteins for LDL

HDL

–good cholesterol, carry cholesterol from organs and blood to liver to get rid of it

• It removes excess cholesterol from tissues

atherosclerosis, heart disease, myocardial infarction

High LDL in blood associated with

Intermediate density lipoproteins

•Product of VLDL catabolism (VLDL remnant)

•Converted to LDL (subclass of LDL)

•Migrates either in pre B or B region in electrophoresis.

•Defective clearance of IDL in type 3 hyperlipoproteinemia is probably due to deficiency of Apo EIII

Lipoprotein a (LPA)

•Known as sinking pre B lipoprotein-  due to electrophoretic mobility same as VLDL but density like LDL.

•Variable migration= pre b, sometimes between LDL and albumin.

•Isolated in the LDL-HDL density range by ultracentrifugation.

•Indicate premature Coronary heart disease and independent risk factor  for atherosclerosis.

•Contains Apo B10

IDL, Lpa

what are the minor lipoportein

lipoprotein X, B-VLDL

what are the Abnormal lipoprotein

lipoprotein X

•Found in obstructive jaundice and LCAT deficiency.

Lipoprotein X

•Specific and sensitive marker for cholestasis.

Lipoprotein X

•Mostly phospholipids and 90% free cholesterol.

• Apo C and albumin

B-VLDL

•Abnormally migrating B VLDL- has the density of VLDL by ultracentrifugation but migrates with LDL in the B region during electrophoresis.

VLDL

In fasting state- most TAG is present in

Chylomicrons

in nonfasting state most TAG is present in

EDTA

the choice for research studies of LLP fractions.

ultracentrifugation

–Reference method for quantitation of LLP

chemical precipitation

–Most consistent analytical error involved in the HDL-Chole assay is due to the presence of apo B containing LLPs.

type I

Familial LPP Lipase deficiency

Type IIa

Familial hypercholesterolemia

Type IIb

Mixed defect Familial combined hyperlipidemia

type III

Familial dysbetalipopreteinemia

type IV

Familial hypertriglyceridemia