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LIPID PROFILE

DISEASE AND
DIAGNOSIS
Submitted By
Geetanjali kumari
8th semester
Ranchi veterinary collage
WHAT DO YOU MEAN BY LIPID
PROFILE?
Lipid profile or lipid panal is a panal of blood
tests that serves as an initial screening tool
for abnormalities in lipids,such as cholesterol
and triglyceride.
Lipid panal test can determine approximate
risks for cardiovascular disease,certain forms
of pancreatitis,and other diseases.
COMPONENTS OF LIPID
PROFILE
The lipid profile typically includes:
 Low density lipoprotein{LDL}
 High density lipoprotein{HDL}
 Triglycerides
 Total cholesterol
 Very low density lipoprotien{VLDL}
 Cholesterol:HDL ratio
LIPID PROFILE
DISEASES/DISORDERS
o Lipid disorders are problems with the various forms
of fat that are carried in the bloodstream.They
include low density lipoproteins(LDL),high density
lipoproteins and triglycerides.
o Lipids donot dissolve in water.For cholesterol and
fatty acids to be carried in the blood and used in
cells, the body use a kind of protein called
apoproteins to transport the lipids through the
blood and into the cells.These protein bound fats
are called lipoproteins.
o Each lipoprotein contains cholesterol,cholesterol
esters,triglycerides,phospholipids,vitamines and
apoproteins.
TYPES OF LIPOPROTEINS
 High density lipoprotein:
HDL is the smallest of the lipoprotein particles.It is the
densest because it contains the highest proportion of
proteins to lipids.
HDL transports cholesterol mostly to the liver or
steroidogenic organs such as adrenals,ovary and testes by
both direct and indirect pathways.
HDL removed by HDL receptors such as scavenger receptor
BI, which mediate the selective uptake of cholesterol
from HDL.
 Low density lipoprotein:

Low density lipoproteins transports cholesterol from the


liver to the tissues of the body.It is called bad
cholesterol because it takes cholesterol to arteries.
LIPOPROTEINS

MAJOR LIPOPROTIENS MINOR LIPOPROTEINS

 CHYLOMICRONS  INTERMEDIATE
 VERY LOW DENSITY DENSITY
LIPOPROTEINS(V.L.D.L LIPOPROTEINS
)  LIPOPROTEIN (a)
 LOW DENSITY  LIPOPROTEIN(x)
LIPOPROTEINS(L.D.L)  Beta –V.L.D.L
 HIGH DENSITY
LIPOPROTEINS(H.D.L)
APOLIPOPROTEIN
 Apolipoproteins are proteins that bind lipids
to form lipoproteins .They transport lipids in
blood,cerebrospinal fluid and lymph.
 FUNCTION
 They are cofactors various enzymes
 Ligands for interaction with lipoprotein
receptors in tissues
 Act as ligand for cell surface receptor
 There are multiple classes for
apolipoproteins and several sub classes:
 Apoliprotein A(APOAI,APOA2,APOA4,APO5)
 Apolipoprotein B(apoB48, apoB100)
 Apolipoprotein C (apo c1,apo c2,apo
c3,apoc4)
 Apolipoprptein D
 Apolipoprotein E
 Apolipoprotein H
 Apolipoprotein L
IMPORTANCE
o Monitoring and maintaining healthy lipid
levels in the blood is crucial to stay healthy.
o It is a good indicator of any cardiovascular
related disease.
o A lipid profile helps the doctor in formulating
a treatment plan.
o Screening for primary and secondary
hyperlipidemias
DISEASES DUE TO LIPID
DISORDERS
LDL-cholesterol Decreased in:
o Severe illness
o Certain drugs
o A beta lipoproteinemia

LDL-cholesterol increased in:


o Familiar hypercholesterolemia
o Familiar combined hyperlipidemia
o Diabetes mellitus
o Nephrosis
o Chronic renal failure
Triglyceride increased in:
o Familiar hypertriglyceridemia
o Von gierke disease
o Diabetes mellitus
o Hypothyroidism
o Nephrosis
o Chronic renal failure
o Drugs
o Serum cholesterol decreased in:
o Severe liver damage
o Hyperthyroidism
o Malnutrition
o Chronic anemia
o Infection
o Drugs
Serum cholesterol increased in:
o Primary hyperlipoproteinemia
o Secondary hyperlipoproteinemia
o Diabetes mellitus
o Hypothyroidism
o Hemodialysis
o Obstructive liver disease
o Chronic alcoholism
HDL Cholesterol decreased in:
o Stress
o Acute myocardial infarction
o Stroke
o Surgery
o Starvation
o Diabetes mellitus
o Liver disease
o Nephrosis
HDL Cholesterol increased in:
o Moderate consumption of alcohol,insulin.
o Hyper alpha lipoprpteinemia
o Hypo beta lipoproteinemia
BLOOD SAMPLING AND STORAGE
Factors that affect lipid profile of blood:
 Posture
 Fasting
 Biological variations(Age,sex,season,food intake)
 Life style factor
 Exercise
 Menstrual cycle
 Alcohal ingestion
 Smoking
 Anticoagulants
STORAGE
 TG,HDL cholesterol,TC can be analysed in
frozen samples
 Apolipoproteins can also be measured in
frozen sample
 Serum/plasma must be stored at -70 deg if
stored for long time
 For short storage the sample can be kept at
-20 deg.
LIPID PROFILE TEST
1. TOTAL LIPID
2. SERUM TOTAL CHOLESTEROL
3. SERUM HDL-C
4. TC/HDL-C
5. SERUM TRIGLYCERIDE
6. SERUM PHOSPHOLIPID
7. ELECTROPHORESIS
A. CHEMICAL METHOD FOR
ESTIMATION OF CHOLESTEROL
1. Modified ABELL KENDALL METHOD
2. PRINCIPLE:
3. Cholesterol esters hydrolysed with alcoholic KOH
4. Unesterified cholesterols are extacted with
petroleum ether.
5. Then they are measured with LIEBERMANN
BURCHARD REAGENT.
6. BURCHARD REAGENT is:
Cholesterol + Sulphuric acid +Acetic anhydride =bluish
green solution.
ENZYMATIC REACTION
 Cholesteryl esters +h20...........cholesterol+
free fatty acids
 Cholesterol +02...............cholesten-4en-
3one +h2o2
 H202 +phenol+4-
aminoantipyrine.......quinoenimine +2h20
 The absorbance of quinoenimine produced is
measured at 500nm.
 Red complex form
TRIGLYCERIDE ENZYMATIC
METHOD
 PRINCIPLE
 Serum TG are hydrolysed to glycerol and free
fatty acids by lipase
 In presense of ATP and glycerokinase,
glycerol is converted to glycerol phosphate
which is then oxidise to yield h202
 H202 react with ESPAS to form colored
complex, the intensity of which is measured
at 546nm.
*ESPAS:N ethyl N sulfopropyl m anizidine
HDL CHOLESTEROL
 HOMOGENOUS ASSAY
 PRINCIPLE
 The method depend on the properties of
detergent which solublizes only the HDL so
that HDL-C is released to react with the
cholesterol esterase and cholesterol oxidised
and chromogen to give color.
 The intensity of color is formed proportional
to concentration of HDL in sample, the
absorbance of which is measured at 600 nm.
LDL- CHOLESTEROL
 FRIDEWALD CALCULATION

 LDL-C(mg/dl) = (TC- HDL CHOLESTEROL)-


PLASMA TG/5
NORMAL LEVEL
LIPID LEVEL(mg/dl)

1. TOTAL LIPID 400-800


2. TOTAL 150-250
CHOLESTEROL 10-90
3. TRIGLYCERIDES 150-380
4. PHOSPHOLIPIDS 9.0-15.0
5. FREE FATTY ACIDS 8.0-11.0
6. PHOSPHOLIPID <150
7. LDL cholesterol <60
8. HDL cholesterol
ESTIMATION OF LIPOPROTIENS
 Ultracentrifugal methods
 Electrophoretic method
 Polyionic precipitation method
LIPOPROTEIN
ELECTROPHORESIS
 USE: identify rare familier disorders (eg type I,
II, III, V Hyperlipidemia)
 PRINCIPLE
 The specimen is applied to a cellulose acetate
plate which has been presoaked in a tris
barbital buffer at ph 8.8.The lipoprotein
fractions are separated by electrophoresis and
then stained with a methanol solution of Fat
red 7B at an alkaline pH.The stained bands
may be visually inspected for qualitative
results or may be quantitated in a scanning
densiometer using a 525nm filter.
LIPOPROTEINS PRESENT ON
ELECTROPHORESIS
Elecrophoretic fraction Finding on ultracentrifugation

Nomigrating band Chylomicrons


LDL
Beta band IDL
VLDL
Broad beta band HDL
Pre beta band
Alpha band
RESULT
 The alpha lipoprotein (HDL) is the fastest
moving fraction and is located closest to the
anode.
 The beta lipoprotein(LDL) band is present at
the origin
 The pre beta lipoprptein(VLDL) band
migrates between alpha and beta
lipoprotein.
COMPLICATION OF
HYPERLIPIDEMIA
 Acute myocardial infarction
 Stroke
 Diabetes mellitus
 Gall stones
 Pancreatitis
 REFERENCE:
 http://en.m.wikipedia.org/wiki/lipid profile
 Slideshare.net
 http://en.m.wikipedia.org/wiki/Apolipoprot
ein
 http://www.ncbi.nlm.nih.gov
 http.//www.cdc.gov(pdf)
 Tietz’s fundamental of clinical chemistry 6/e
THANK YOU