コレステロール分画・トリグリセライド分画同時解析法による特殊なパターンの分類と臨床的意義

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  • Classification and clinical significance of abnormal lipoprotein patterns using simultaneous determination of serum cholesterol and triglyceride fractions.
  • コレステロール ブンカク トリグリセライド ブンカク ドウジ カイセキホウ ニ ヨル トクシュ ナ パターン ノ ブンルイ ト リンショウテキ イギ

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The WHO Hyperlipoproteinemia phenotype was classified automatically by fractionations of cholesterol and TG using agarose gel electrophoresis with differential staining. Using this technique, clinical significance of samples, heretofore unclassifiable due to abnormal fractions, was examined.<br>The abnormal LDL was TG-rich LDL results in peak TG concentrations consistent with LDL migration. HDL and VLDL fractions are hardly affected. This abnormal band appears with advanced liver function degradation and was classified into 3 types: Type A, a narrow LDL band, Type B, a wide LDL band, and Type C, minimal HDL and VLDL bands. Type B appears associated with malignant tumors.<br>Lp-X is a Cholesterol rich band and appears electrophoretically on the catholic side of LDL. The presence of Lp-X is associated with jaundice and advanced cholestasis. Lp-Y resembles Lp-X relative to mobility and pathology, but contains Cholesterol and TG. Poor prognosis is anticipated with the presence of these abnormal LDL, Lp-X and Lp-Y fractions.<br>Slow αHDL bands appear in the patient with slight bile stagnation and is accompanied with increased Apo E with positive prognosis.<br>IDL, (VLDL remnant), is the TG-rich band appearing between VLDL and LDL. Lp(a) appears between VLDL and LDL, but is distinguishable from IDL due to the“sharp-banding” and its Cholesterol-rich content.<br>The simultaneous analysis of Cholesterol and TG fractions can satisfactorily interpret the WHO Hyperlipoproteinemia phenotype with their elevated Cholesterol and TG containing fractions. This test is useful in assessing pathology associated with metabolic lipoprotein disorders.

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