Hyperlipidemia in the Pacific Northwest Bell Telephone Company Health Survey. Part 1. Lipoprotein cholesterol and triglyceride concentrations.

Abstract

Lipoprotein triglyceride and cholesterol concentrations and characteristics are described in normolipidemic and in three categories of hyperlipidemic subjects participating in the Pacific Northwest Bell Telephone Company Health Survey. For this study, 350 white participants 20 to 59 years of age with cholesterol or triglyceride values exceeding the age, sex, and hormone-use specific, population-based 90th percentile values were defined as having hypercholesterolemia, hypertriglyceridemia, or combined hyperlipidemia; 722 participants were classified as normolipidemic. In hypercholesterolemia, very low density lipoprotein cholesterol and triglyceride and high density lipoprotein cholesterol concentrations were higher than in normolipidemia. In hypertriglyceridemia, high density lipoprotein cholesterol was significantly lower in men and women not using sex hormones and low density lipoprotein triglyceride was significantly higher in men and women using hormones compared to normolipidemia. In combined hyperlipidemia, high density lipoprotein cholesterol concentrations were lower than in normolipidemia, but higher than in pure hypertriglyceridemia. The presence of beta migrating very low density lipoprotein and chylomicrons was seen primarily in hypertriglyceridemic or combined hyperlipidemic men. Sinking prebeta lipoprotein was equally common (20%) among all normolipidemic and hypercholesterolemic subjects, but was less common (5% to 10%) in hypertriglyceridemic and combined hyperlipidemic men and female hormone users. Quantitative and qualitative lipoprotein abnormalities associated with hyperlipidemia were found to vary by gender and by sex hormone use in women and were often, but not always, more marked in men. (Arteriosclerosis 3:117-124, March/April 1983)

Physiologic and supraphysiologic increases in lipoprotein lipids and apoproteins in late pregnancy and postpartum. Possible markers for the diagnosis of "prelipemia".

“…An HDL cholesterol reduction intermediate between normal and endogenous hypertriglyceridemia is characteristic of familial combined hyperiipidemia 20 and combined hyperiipidemias in general. 22 -A final argument that a supraphysiologic rise in plasma triglyceride antepartum is a pathophysiologic process signifying an underlying prelipemic trait is based on the fact that all three subjects for whom relatives were available show evidence of hyperlipidemia among family members. The difference among the subjects' responses to pregnancy, as well as the available information among relatives, suggests that the designation of prelipemia could represent several distinct and possibly genetic underlying disorders of lipoprotein metabolism.…”

Hyperlipidemia in the Pacific Northwest Bell Telephone Company Health Survey. Part 2. Lipoprotein lipid interrelationships.

“…4 With respect to VLDL and LDL, an increase in the cholesterol/triglyceride ratio could signify an increase in lipoprotein remnants in the VLDL fraction or a more smectic, less liquid crystalline structure in LDL. Ratio increases in both lipoprotein fractions could enhance the potential for atherogenesis on the basis of the human model of "remnant removal disease" 18 and primate models of the varied atherogenicity of LDL.…”

“…19 In hypertriglyceridemia, the cholesterol/triglyceride ratio is low, reflecting the higher concentration of triglyceride in each fraction. 4 Compared to normolipidemia, men experience the least decrement in the VLDL ratio, a potentially atherogenic bias. However, men also have the greatest reduction in the LDL ratio, a potentially antiatherogenic bias (figure 1).…”

“…3 More recently, we have examined the data from hyperlipidemic subjects in our population for lipoprotein lipid differences associated with gender and sex hormone treatment. 4 Three categories of hyperlipidemia were defined by age, sex, and hormone usespecific, population-based reference values of cholesterol and triglyceride. In addition to the expected very low density lipoprotein (VLDL) and low density lipoprotein (LDL) abnormalities, other differences were observed in lipoprotein lipid concentrations in the hyperlipidemic subjects.…”