How to remember lipoprotein disorders

Hello everyone!

Click here to read about Lipoproteins and apoproteins if you need a quick revision before we get started :)

In this blog post, I’ll be talking about lipoprotein disorders, how to remember them and some facts that you need to know about the disorders.
Type I hyperlipoproteinemia
Chylomicrons increased in childhood.
VLDL increased later in life.

Lab findings: Increase in serum triglycerides.

Why?
CPL (Capillary lipprotein lipase) hydrolyzes triglycerides in lipoproteins.
It requires apo-CII as a co-factor.

Clinical findings: Acute pancreatitis (Pancreatic vessels filled with chylomicrons rupture), eruptive xanthomas.
Type II hyperlipoproteinemia
Serum LDL is increased.

Lab findings:
In IIa, only cholesterol is increased.

Why?
Liver cholesterol synthesis is deprived of negative feedback.

In IIb, cholesterol and triglycerides are increased.

Why?
Liver overproduces VLDL in IIb

Acquired causes: Primary hypothyroidism, nephrotic syndrome, extrahepatic cholestasis.

Clinical findings: Tendon xanthomas, Xanthelasma, premature coronary artery disease and stroke.
Type III hyperlipoproteinemia
This dysbetalipoproteinemia is also known as “remnant disease”.

Lab findings: Elevation in cholesterol and triglyceride levels.

Why?
Apo E is required to remove chylomicron remnants and IDL (remnant of VLDL).

Clinical findings: Palmar xanthomas, increased risk for coronary artery and peripheral vascular disease.
Type IV hyperlipoproteinemia
Increase in VLDL.

Lab findings: TG accumulates
in preference to cholesterol, like IIb.

Acquired causes: Excess alcohol, OCPs, Diabetes mellitus, chronic renal failure, thiazides, beta blockers.

Clinical findings: Eruptive xanthomas, increased risk for coronary artery and peripheral vascular disease.
Type V hyperlipoproteinemia
Increase in chVlomicrons and VLDL.
It is a mixture of types I and IV familial dyslipidemias.
Lab findings: TG levels are high, whereas cholesterol concentration increases only moderately.
Clinical findings: Like type I, but unlike type IV, there is no major risk of atherosclerosis, so that pancreatitis and eruptive xanthomas remain the main complications.
For the sake of completion, I’d like to add another disease -
Tangier disease is due to lack of ABC1 cholesterol transporter gene.
Cholesterol accumulates inside cells. Blood HDL and cholesterol are low.
The disease is characterized by atherosclerosis, hepatosplenomegaly, polyneuropathy and orange tonsils.

*phew* That’s all!

Like I always say, if you stare at a word long enough, you find the mnemonic in the word itself :P
I made these myself, hope you find them helpful ^__^

Happy Indian Independence Day :)

-IkaN
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