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WHO/Fredrickson classification of primary hyperlipidaemias

Authoring team

Frederickson Classification of Lipid Disorders

Type

Average of overnight serum

Elevated particles

Associated clinical disorders

Serum TC

Serum TG

I

Creamy top layer

Chylomicrons

 

Lipoprotein lipase deficiency, apolipoprotein C-II deficiency

 

N

++

IIa

Clear

LDL

 

Familial hypercholesterolemia, polygenic hypercholesterolemia, nephrosis, hypothyroidism, familial combined hyperlipidemia

 

++

N

IIb

Clear

LDL, VLDL

 

Familial combined hyperlipidemia

 

++

+

III

Turbid

IDL

 

Dysbetalipoproteinemia

 

+

+

IV

Turbid

VLDL

 

Familial hypertriglyceridemia, familial combined hyperlipidemia, sporadic hypertriglyceridemia, diabetes

 

N+

++

V

Creamy top, turbid bottom

Chylomicrons, VLDL

Diabetes

+

++

Note that the WHO classification is simply a biochemical phenotypic classification based on which lipoprotein is raised. Also the classification was devised before the importance of HDL as a prognostic indicator was recognised.

* IDL = intermediate-density lipoproteins; LDL = low-density lipoproteins; TC = total cholesterol; TG = triglycerides; VLDL = very low-density lipoproteins;

+ = increased; ++ = greatly increased; N= normal; N+ = normal or increased


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