Classification of Hyperlipidemias – howMed

For the purposes of diagnosis and treatment the most convenient classification is that which is based on the type of lipid abnormality (cholesterol, TG, or both).

1. Primary hyperlipidaemias

Hypercholesterolaemia

Hypertriglyceridaemia

Familial lipoprotein lipase (LPL) deficiency
Familial apolipoprotein C-II deficiency
Familial hypertriglyceridaemia

Combined hypertriglyceridaemia and hypercholesterolaemia

Familial combined hyperlipidaemia
Familial type 3 hyperlipoproteinaemia

2. Secondary hyperlipidaemias

Hypercholesterolaemia

Hypothyroidism
Obstructive jaundice
Acute porphyria
Growth hormone deficiency
Drugs: corticosteroids

Hypertriglyceridaemia

Diabetes mellitus (DM)
Alcoholism
Lipodystrophies
Renal failure
Oestrogens (pregnancy,oral contraceptives)
Glycogen storage disease
Systemic lupus erythematosis (SLE)
Obesity
Severe stress
Thiazides

Combined hypertriglyceridaemia and hypercholesterolaemia

Nephrotic syndrome
Myelomatosis
Diabetes mellitus (DM)
Renal failure

Fredrickson Classification

WHO (Fredrickson) classification of hyperlipidaemias, based on the electrophoeretic pattern of lipoproteins is as follows:

Types /Classification	Seen on Electrophoresis	Which Lipoprotein are increased	Which Lipids increased
I	Increased chylomicrons zone	Chylomicrons	Triglyceride
IIa	Increased beta-lipoproteins zone	LDL-c	Cholesterol
IIb	Increased pre-beta and beta lipoproteins zone	VLDL and IDL-c	Cholesterol and Triglyceride
III	Beta band is broad in beta band zone	IDL-c	Cholesterol and Triglyceride
IV	Increased pre-beta lipoprotein zone	VLDL	Triglyceride
V	Increased pre-beta lipoprotein zone and chylomicrons zone	VLDL and chylomicrons	Cholesterol and Triglyceride