Biochemical typing of hyperlipoproteinemia. The development of a nomogram

Abstract

The accurate biochemical typing of hyperlipoproteinemia would require quantification of lipoprotein fractions. At present, typing is frequently based on the lipoprotein electrophoresis pattern together with serum lipid analyses. Lack of facilities for lipoprotein electrophoresis has however focused the clinical interest for classification of hyperlipoproteinemia into other means of a simple biochemical typing. In the present study a nomogram was developed to allow biochemical typing of hyperlipoproteinemia from serum cholesterol and triglyceride values. Serum cholesterol was determined according to a Liebermann-Burchard reaction by the method of Cramer and Isaksson [1], serum triglycerides by the determination of glyceride glycerol according to Carlson [2], and serum lipoprotein electrophoresis was performed on agarose gel [3]. Cholesterol content [4] of alpha-lipoproteins ("alpha-LP cholesterol") was obtained in serum after the precipitation of very-low-density lipoproteins(VLDL) and low-density lipoproteins(LDL) by manganese chloride and heparin [5]. Preparative ultracentrifugation was performed in a one-step, gradient procedure [6] isolating VLDL, d less than 1.006, LDL, d 1.006--1.063 g/ml and high-density lipoprotein (HDL) including very-high-density lipoproteins, d greater than 1.063 g/ml, or alternatively at d 1.006 g/ml according to the procedure by Gustafson et al. [7].