Ratio of Remnant-like Particle-Cholesterol to Serum Total Triglycerides Is an Effective Alternative to Ultracentrifugal and Electrophoretic Methods in the Diagnosis of Familial Type III Hyperlipoproteinemia

• Published in: Clinical chemistry (Baltimore, Md.) Md.), 1999-11, Vol.45 (11), p.1981-1987
• Main Authors: Wang, Tao, Nakajima, Katsuyuki, Leary, Elizabeth Teng, Warnick, G. Russ, Cohn, Jeffrey S, Hopkins, Paul N, Wu, Lily L, Cilla, Donald D, Zhong, Jianhua, Havel, Richard J
• Format: Article
• Language: English
• Subjects: Apolipoproteins - blood; Biological and medical sciences; Cholesterol; Cholesterol, VLDL - blood; Disorders of blood lipids. Hyperlipoproteinemia; Electrophoresis; Female; Humans; Hyperlipoproteinemia Type III - blood; Hyperlipoproteinemia Type III - diagnosis; Investigative techniques, diagnostic techniques (general aspects); Lipoproteins - blood; Male; Medical sciences; Metabolic diseases; Middle Aged; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Reference Values; Triglycerides - blood; Ultracentrifugation
• ISSN: 0009-9147; 1530-8561

Familial type III hyperlipoproteinemia (HLP) is characterized by the presence of beta-migrating VLDL (beta-VLDL) and increased risk of cardiovascular disease. Assessment of plasma beta-VLDL is achieved by measuring the ratio of VLDL-cholesterol (VLDL-C) to total plasma triglycerides (TGs) or by detecting beta-VLDL in total VLDL. The objective of this study was to compare the clinical utility of the ratio of remnant-like particle-cholesterol (RLP-C) to total TGs with that of the current methods for diagnosing type III HLP. Detection of beta-VLDL by electrophoresis of VLDL was used to define type III HLP. Twenty-eight patients with type III HLP and 43 subjects lacking beta-VLDL were investigated. Fasting TG concentrations were >2.26 mmol/L in all subjects. Subjects were separated into three groups: group 1, serum total cholesterol 5.18 mmol/L and TGs between 2.26 and 9.04 mmol/L (n = 51); and group 3, TGs >9.04 mmol/L (n = 9). In group 2, a RLP-C-to-total TG molar ratio >/=0.23 (>/=0.10 when using mg/dL) and a VLDL-C-to-total TG molar ratio >/=0.69 (>/=0.30 when using mg/dL) correctly classified 94% and 90% of the subjects, respectively. The utility of the RLP-C-to-total TG ratio in diagnosing type III HLP decreased in patients in the other two groups. When used in an appropriate target population, the RLP-C-to-total TG ratio is a convenient and effective alternative to ultracentrifugal and electrophoretic methods for diagnosing type III HLP.