Plasma lipid profiles: the expanding repertoire of tests, their clinical significance and pitfalls.
Hyperlipidaemia and in particular hypercholesterolaemia is the best established cause of atherosclerosis. As awareness of this association grows amongst a more informed populace, there will be an increasing demand for plasma lipid screening. The traditional measurements of total plasma cholesterol and triglycerides for the assessment of hyperlipidaemia and its attendant CHD risk are now augmented by the availability of routine methods for separating and quantitating the different plasma lipoproteins, thus vastly improving diagnostic sensitivity. Because it is the major carrier of cholesterol in plasma and because the mechanistic evidence relating it to atherogenesis is strongest, elevated levels of the low density lipoproteins (LDL) are undesirable: high levels of high density lipoproteins (HDL), on the other hand, decrease the risk. Currently, plasma LDL and HDL concentrations are most frequently assessed by measuring their cholesterol content. However, the measurement of apolipoproteins, the protein components of the lipoproteins, may yet prove to be superior in predictive value, though they can hardly be expected to replace the older tests as first line screening tests by virtue of their relative costs and sophistication in terms of instrumentation and techniques. Additional diagnostic tests have been developed and newer ones will no doubt continue to evolve with further technical advancements and a better understanding of the pathogenesis of atheromas and vessel disease. The current lineup includes HDL subfractions, unique lipoproteins such as Lp(a) and beta-migrating VLDL and apolipoprotein E variants.(ABSTRACT TRUNCATED AT 250 WORDS)
Koay
E S
ES
Department of Pathology, National University of Singapore.
D001053:Apolipoproteins / Q000097:blood; D001161:Arteriosclerosis / Q000097:blood / Q000209:etiology; D001693:Biological Transport, Active; D001774:Blood Chemical Analysis / Q000379:methods / Q000592:standards; D002784:Cholesterol / Q000097:blood; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000175:diagnosis; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood
D001053:Apolipoproteins; D008055:Lipids; D008074:Lipoproteins; D002784:Cholesterol