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primary hyperlipidaemias (WHO/Fredrickson classification)

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Frederickson Classification of Lipid Disorders

Type Average of overnight serum Elevated particles Associated clinical disorders Serum TC Serum TG
I Creamy top layer Chylomicrons

 

Lipoprotein lipase deficiency, apolipoprotein C-II deficiency

 

N ++
IIa Clear LDL

 

Familial hypercholesterolemia, polygenic hypercholesterolemia, nephrosis, hypothyroidism, familial combined hyperlipidemia

 

++ N
IIb Clear LDL, VLDL

 

Familial combined hyperlipidemia

 

++ +
III Turbid IDL

 

Dysbetalipoproteinemia

 

+ +
IV Turbid VLDL

 

Familial hypertriglyceridemia, familial combined hyperlipidemia, sporadic hypertriglyceridemia, diabetes

 

N+ ++
V Creamy top, turbid bottom Chylomicrons, VLDL Diabetes + ++

Note that the WHO classification is simply a biochemical phenotypic classification based on which lipoprotein is raised. Also the classification was devised before the importance of HDL as a prognostic indicator was recognised.

* IDL = intermediate-density lipoproteins; LDL = low-density lipoproteins; TC = total cholesterol; TG = triglycerides; VLDL = very low-density lipoproteins;

+ = increased; ++ = greatly increased; N= normal; N+ = normal or increased

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