Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep;15(5):1195-1202.
doi: 10.5114/aoms.2019.87207. Epub 2019 Aug 22.

Characterization of lipoprotein profiles in patients with hypertriglyceridemic Fredrickson-Levy and Lees dyslipidemia phenotypes: the Very Large Database of Lipids Studies 6 and 7

Renato Quispe  1   2 , Aditya D Hendrani  1   3 , Behnoud Baradaran-Noveiry  1 , Seth S Martin  1   4 , Emily Brown  5 , Krishnaji R Kulkarni  6 , Maciej Banach  7 , Peter P Toth  1   8   9 , Eliot A Brinton  10 , Steven R Jones  1 , Parag H Joshi  1   11
Affiliations

Characterization of lipoprotein profiles in patients with hypertriglyceridemic Fredrickson-Levy and Lees dyslipidemia phenotypes: the Very Large Database of Lipids Studies 6 and 7

Renato Quispe et al. Arch Med Sci. 2019 Sep.

Abstract

Introduction: The association between triglycerides (TG) and cardiovascular diseases is complex. The classification of hypertriglyceridemic (HTG) phenotypes proposed by Fredrickson, Levy and Lees (FLL) helps inform treatment strategies. We aimed to describe levels of several lipoprotein variables from individuals with HTG FLL phenotypes from the Very Large Database of Lipids.

Material and methods: We included fasting samples from 979,539 individuals from a contemporary large study population of US adults. Lipids were directly measured by density-gradient ultracentrifugation using the Vertical Auto Profile test while TG levels were measured in whole plasma using the Abbott ARCHITECT C-8000 system. Hyperchylomicronemic (Hyper-CM) and non-chylomicronemic (non-CM) phenotypes were defined using computationally derived models. Individuals with FLL type IIa phenotype were excluded. Distributions of lipid variables were compared using medians and Kruskal-Wallis test.

Results: A total of 11.9% (n = 116,925) of individuals met criteria for HTG FLL phenotypes. Those with hyper-CM phenotypes (n = 5, < 0.1% of population) had two-fold higher TG levels compared with non-chylomicronemic (non-CM) individuals (11.9% of population) (p < 0.001). Type IIb individuals had the highest non-HDL-C levels (median 242 mg/dl). Cholesterol in large VLDL1+2 particles was higher than in small VLDL3 particles in all phenotypes except FLL type III. Hyper-CM phenotypes had significantly lower HDL-C levels but greater HDL2/HDL3-C ratio compared to non-CM phenotypes. Cholesterol content of the lipoprotein (a) peak was significantly higher in the hyper-CM groups compared to non-CM phenotypes (p < 0.0001).

Conclusions: This observational hypothesis-generating study provides insight into the complexity of lipid metabolism in HTG phenotypes, including less traditional lipid measures such as LDL density, HDL subclasses and Lp(a)-C.

Keywords: Fredrickson-Levy phenotypes; dyslipidemia; hypertriglyceridemia.

PubMed Disclaimer

Conflict of interest statement

Drs. Martin and Jones are listed as coinventors on a pending patent filed by Johns Hopkins University for LDL-C estimation. Dr Jones has served as an advisor to Sano/Regeneron. Dr Martin has served as a consultant to Quest Diagnostics, Sano/Regeneron, Amgen, and the Pew Research Center. Dr. Joshi received non-compensated site PI for studies funded by AstraZeneca, Pfizer, Merck and Regeneron/Sanofi as well as modest consulting income from Regeneron. Dr. Toth has served as consultant and speaker for Amarin, Amgen, Kowa, Merck, Novo-Nordisk, Regeneron, and Sanofi; consultant to Gemphire. Dr. Brinton has received research support from Amarin, Kowa and the National Institutes of Health; honoraria as consultant for Akcea, Alexion, Amarin, Amgen, Janssen, Kastle, Kowa, Merck, Precision Biosciences, PTS Diagnostics, Regeneron, Sanofi-Aventis; honoraria as speaker for Akcea, Alexion, Amarin, Amgen, Boehringer-Ingelheim, Janssen, Kastle, Kowa, Merck, Novo-Nordisk, Regeneron, Sanofi-Aventis.

Figures

Figure 1
Figure 1
Levels of triglycerides and cholesterol measures in hyper-chylomicronemic and non-chylomicronemic phenotypes in the Very Large Database of Lipids study
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292–333. - PubMed
    1. Soran H, Adam S, Mohammad JB, et al. Hypercholesterolaemia – practical information for non-specialists. Arch Med Sci. 2018;14:1–21. - PMC - PubMed
    1. Fredrickson DS, Lees RS. A system for phenotyping hyperlipoproteinemia. Circulation. 1965;31:321–7. - PubMed
    1. Brahm A, Hegele RA. Hypertriglyceridemia. Nutrients. 2013;5:981–1001. - PMC - PubMed
    1. Beaumont JL, Carlson LA, Cooper GR, Fejfar Z, Fredrickson DS, Strasser T. Classification of hyperlipidaemias and hyperlipoproteinaemias. Bull World Health Organ. 1970;43:891–915. - PMC - PubMed