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hyperlipoproteinemia type 4
Etiology:
1) familial form
2) secondary form
a) often associated with obesity &/or glucose intolerance
b) alcohol abuse
c) oral estrogen/progesterone-containing contraceptives
Epidemiology:
1) common
2) most common form of hypertriglyceridemia
3) patients may fluctuate between types 4 & 5
Pathology:
1) excess in apolipoprotein C3
2) inhibits lipoprotein & hepatic lipase
Genetics:
-> generally autosomal recessive
Laboratory:
1) elevated serum triglycerides & VLDL
2) normal serum cholesterol
3) HDL-cholesterol is often low
Management:
1) correct precipitating causes
a) obesity
b) diabetes
c) alcohol
d) oral contraceptives
2) most patients with familial forms are very sensitive to calorie restriction
3) use of anti-hyperlipidemic agents is rarely necessary
a) fibrates are most commonly used
b) niacin may be used if fibrate plus diet is unsuccessful
c) large doses of fish oil have been used (6-8 g/day)
Related
apolipoprotein C3; apo-CIII (APOC3)
fibrate
nicotinic acid (niacin, vitamin B3, Niaspan)
General
hyperlipoproteinemia (HLP)
lipid metabolism, inborn error; lipid storage disease; lipidosis
Figures/Diagrams
Figures/diagrams/slides/tables related to hyperlipoproteinemia type 4
References
- Clinical Diagnosis & Management by Laboratory Methods,
J.B. Henry (ed), W.B. Saunders Co., Philadelphia,
PA. 1991, pg 209
- Tietz Textbook of Clinical Chemistry, 2nd ed. Burtis CA &
Ashwood ER (eds), WB Saunders Co, Philadelphia PA, 1993,
pg 1044