A new phenotypic classification system for dyslipidemias based on the standard lipid panel

Lipids in Health and Disease

Peter Wilson¹  Robert S. Rosenson²  Daniel Soffer³  Erica Fatica⁴  Leslie J. Donato⁴  Jeff Meeusen⁴  Maureen Sampson⁵  James D. Otvos⁶  Rami A. Ballout⁷  Marcelo Amar⁷  Alan T. Remaley⁷  Anna Wolska⁷  Sotirios K. Karathanasis⁷  Robert Shamburek⁷  Sierra Wilson⁷  Eliot A. Brinton⁸ 

[1] Atlanta VAMC and Emory Clinical Cardiovascular Research Institute, 30322, Atlanta, GA, USA;Cardiometabolics Unit, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Department of Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA;Department of Laboratory Medicine and Pathology, Mayo Clinic, 55905, Rochester, MN, USA;Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA;Laboratory Corporation of America Holdings (LabCorp), Burlington, NC, USA;Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bldg. 10/Rm. 2C433, 20892, Bethesda, MD, USA;Utah Lipid Center, Salt Lake City, UT, USA;

关键词: Cholesterol;    LDL;    Lipids;    Lipoproteins;    Genetics;    Cardiovascular disease;   

DOI  :  10.1186/s12944-021-01585-8

来源: Springer

【 摘 要 】

BackgroundDyslipoproteinemias can be classified by their distinct lipoprotein patterns, which helps determine atherosclerotic cardiovascular disease (ASCVD) risk and directs lipid management but this has required advanced laboratory testing.ObjectiveTo develop a new algorithm for classifying lipoprotein disorders that only relies on the standard lipid panel.MethodsLipid thresholds for defining the different lipoprotein phenotypes were derived for Non-High-Density Lipoprotein-Cholesterol (NonHDL-C) and Triglycerides (TG) to be concordant when possible with the current US Multi-Society guidelines for blood cholesterol management.ResultsThe new classification method categorizes patients into all the classical Fredrickson-like phenotypes except for Type III dysbetalipoproteinemia. In addition, a new hypolipidemic phenotype (Type VI) due to genetic mutations in apoB-metabolism is described. The validity of the new algorithm was confirmed by lipid analysis by NMR (N = 11,365) and by concordance with classification by agarose gel electrophoresis/beta-quantification (N = 5504). Furthermore, based on the Atherosclerosis Risk in Communities (ARIC) cohort (N = 14,742), the lipoprotein phenotypes differ in their association with ASCVD (TypeV>IIb > IVb > IIa > IVa > normolipidemic) and can be used prognostically as risk enhancer conditions in the management of patients.ConclusionsWe describe a clinically useful lipoprotein phenotyping system that is only dependent upon the standard lipid panel. It, therefore, can be easily implemented for increasing compliance with current guidelines and for improving the care of patients at risk for ASCVD.

【 授权许可】

CC BY