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The use of the esterified fatty acid index in the classification and quantitation of hyperlipoproteinaemias

  • J.D. Billimoria
    Correspondence
    Requests for reprints should be addressed to J. D. B., Department of Chemical Pathology, Westminster Medical School, Research Laboratories, Udall Street, London SW1, Great Britain.
    Affiliations
    Department of Chemical Pathology, Westminster Medical School, Research Laboratories, Udall Street, London SW1 Great Britain
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  • M.F. Fahmy
    Affiliations
    Department of Chemical Pathology, Westminster Medical School, Research Laboratories, Udall Street, London SW1 Great Britain
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  • E.M. Jepson
    Affiliations
    Department of Chemical Pathology, Westminster Medical School, Research Laboratories, Udall Street, London SW1 Great Britain
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  • N.F. Maclagan
    Affiliations
    Department of Chemical Pathology, Westminster Medical School, Research Laboratories, Udall Street, London SW1 Great Britain
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      Abstract

      A quantitative study of the serum lipoprotein electrophoresic patterns of 87 subjects has been conducted. After electrophoresis and staining with oil red O the bands as observed by reflectance scanning were cut and the colour eluted by solvents. From the relative dye uptake and total esterified fatty acid content of the serum an “esterified fatty acid index” (EFI) was ascribed to each lipoprotein band.
      The upper limits of the beta and pre-beta EFI for controls 40–70 years were 180 and 120 and for controls 19–39 years were 140 and 70 respectively.
      Hyperlipoproteinaemias are classified as follows:
      If the beta EFI is greater than normal and pre-beta is normal the serum is Class B (hyper beta lipoproteinaemia). A broad beta without chylomicronaemia (requires no quantitation) is termed broad beta lipoproteinaemia. When beta and pre-beta are above normal, if the ratio of pre-beta: beta is greater than 0.5, the serum is Class PB and if it is less than 0.5 the serum is Class BP (mixed hyper beta-pre-beta lipoproteinaemias). If only the pre-beta EFI is elevated the serum is Class P (hyper pre-beta lipoproteinaemia). A broad beta or raised beta and pre-beta with chylomicronaemia is indicated by Class CPB (mixed hyperlipoproteinaemia with chylomicronaemia). The sera of 43 patients were classified as above and our classification is compared with the well established systems of Fredrickson et al.4 and that of Strisower et al.2 In 13 patients presenting with IHD 5 had hyperlipoproteinaemia and 8 fell within the upper normal range. Their patterns tend to resemble Class P.
      Only 1 case of hyperchylomicronaemia has been observed and a Class C is reserved for this group.

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