Lipoprotein-X and Lipoprotein-Z Induced Hyperviscosity Syndrome in the Setting of Cholestatic Liver Failure

Waksman, Ori; Cho, Daniel J.; Kim, HyoungSup; Otvos, James D.; Rosenson, Robert S.

doi:10.1016/j.jaccas.2022.09.001

Cited by 3 publications

(1 citation statement)

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“…With that said, in a single case report of drug-induced liver injury leading to cholestasis, NMR-measured LP-X levels appeared to correlate with the clinical presentation, suggesting that the NMR test can be used as a simple means to detect LP-X particles in a patient sample and enable a more sophisticated interpretation of unusually high cholesterol levels. However, future work is necessary to assess the correspondence between the NMR assay and other assays that detect LP-X and to establish the clinical utility of this assay [52].…”

Section: Discussionmentioning

confidence: 99%

A High-Throughput NMR Method for Lipoprotein-X Quantification

Garcia,

Shalaurova,

Matyus

et al. 2024

Molecules

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Lipoprotein X (LP-X) is an abnormal cholesterol-rich lipoprotein particle that accumulates in patients with cholestatic liver disease and familial lecithin–cholesterol acyltransferase deficiency (FLD). Because there are no high-throughput diagnostic tests for its detection, a proton nuclear magnetic resonance (NMR) spectroscopy-based method was developed for use on a clinical NMR analyzer commonly used for the quantification of lipoproteins and other cardiovascular biomarkers. The LP-X assay was linear from 89 to 1615 mg/dL (cholesterol units) and had a functional sensitivity of 44 mg/dL. The intra-assay coefficient of variation (CV) varied between 1.8 and 11.8%, depending on the value of LP-X, whereas the inter-assay CV varied between 1.5 and 15.4%. The assay showed no interference with bilirubin levels up to 317 mg/dL and was also unaffected by hemolysis for hemoglobin values up to 216 mg/dL. Samples were stable when stored for up to 6 days at 4 °C but were not stable when frozen. In a large general population cohort (n = 277,000), LP-X was detected in only 50 subjects. The majority of LP-X positive cases had liver disease (64%), and in seven cases, had genetic FLD (14%). In summary, we describe a new NMR-based assay for LP-X, which can be readily implemented for routine clinical laboratory testing.

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Section: Discussionmentioning

confidence: 99%