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WHO/Fredrickson classification of primary hyperlipidaemias

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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