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Current Cardiology Reports

, 20:88 | Cite as

Which Lipids Should Be Analyzed for Diagnostic Workup and Follow-up of Patients with Hyperlipidemias?

  • Michel R. Langlois
  • Børge G. Nordestgaard
Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lipid Abnormalities and Cardiovascular Prevention

Abstract

Purpose of Review

To summarize and discuss the clinical use of lipid and apolipoprotein tests in the settings of diagnosis and therapeutic follow-up of hyperlipidemia.

Recent Findings

The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently produced recommendations on the measurement of atherogenic lipoproteins, taking into account the strengths and weaknesses of analytical and clinical performances of the tests.

Summary

Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (= LDL + remnant cholesterol) constitute the primary lipid panel for hyperlipidemia diagnosis and cardiovascular risk estimation. LDL cholesterol is the primary target of lipid-lowering therapies. Non-HDL cholesterol or apolipoprotein B should be used as secondary therapeutic target in patients with mild-to-moderate hypertriglyceridemia, 2–10 mmol/l (175–880 mg/dl). Lipoprotein (a) is included in LDL cholesterol and should be measured at least once in all patients at cardiovascular risk, including to explain poor response to statin treatment.

Keywords

Lipids Apolipoproteins Hyperlipidemia Diagnosis Cardiovascular risk estimation Therapeutic follow-up 

Abbreviations

apoA-I

Apolipoprotein A-I

apoB

Apolipoprotein B

CETP

Cholesteryl ester transfer protein

CHD

Coronary heart disease

CVD

Cardiovascular disease

FCH

Familial combined hyperlipidemia

FH

Familial hypercholesterolemia

HDL (C)

High-density lipoprotein (cholesterol)

HL

Hepatic lipase

IDL

Intermediate-density lipoprotein

KIV-2

Kringle IV type 2

LCAT

Lecitin:cholesterol acyltransferase

LDL (C)

Low-density lipoprotein (cholesterol)

cLDLC

Calculated LDL cholesterol

Lp (a)

Lipoprotein (a)

LPL

Lipoprotein lipase

NMR

Nuclear magnetic resonance

PCSK9

Proprotein convertase subtilisin/kexin type 9

Remnant-C

Remnant lipoprotein cholesterol

SCORE

Systematic coronary risk evaluation

TC

Total cholesterol

TG

Triglycerides

VLDL (C)

Very low-density lipoprotein (cholesterol)

Notes

Compliance with Ethical Standards

Conflict of Interest

Michel R. Langlois reports an educational grant from Roche Diagnostics and speaker honorarium from Amgen.

Børge G. Nordestgaard reports being the Danish tax payer for education, wages and research funding; and consultancies or talks sponsored by AstraZeneca, Sanofi, Regeneron, Ionis, Akcea, Amgen, Kowa, Denka Seiken.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.AZ St.-Jan HospitalDepartment of Laboratory MedicineBruggeBelgium
  2. 2.University of GhentGhentBelgium
  3. 3.Department of Clinical Biochemistry, Herlev and Gentofte HospitalCopenhagen University Hospital, University of CopenhagenCopenhagenDenmark

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