Lipids in Clinical Chemistry

39 terms by bdsowder 

Ready to study?
Start with Flashcards

Create a new folder

Advertisement Upgrade to remove ads

What is a lipoprotein?

Molecules that interact with water insoluble fat molecules ad tansports them in the plasma. They allow the to be dissolved in the plasma.

What are the four types of proteins?

Chylomicrons
VLDL
LDL
HDL

Chylomicrons

Transports dietary triglycerides from the GI tract to the liver.
Absent from fasting plasma
Removed from the plasma within 6 hours by the liver.
Inadequate clearance produces a creamy layer on plasma

Very Low Density Lipoprotein VLDL

Transports triglcerides from the liver to the tissues for storage and energy.
Excess dietary carbs are convertd to triglycerides by the liver.

Low Density Lipoprotein LDL

Transports cholesterol to the peripheral tissues.
BAD cholesterol
50 - 65% by weight is triglycerides
LDL= T.cholesterol - (HDL +VLDL) Tri / 5

High Density Lipoproteins HDL

Transports cholesterol away from the peripheral tissues to the liver.
Synthesized in the liver and intestines.
GOOD cholesterol

Lipids include:

Cholesterol
Triglycerides
Phospholipids
Glycoproteins

Saturated fatty acids

Single bonded carbons
Solid at room temp
Animal sources

Unsaturated fatty acids

Double bonded carbons
Usually liquid at Room Temp
Plant sources

Triglycerides

Glycerol with 3 attached fatty acids
Dietary source
Liver and tissue storage

Triglycerides

95% of the bodys fat
Energ source when plasma glucose is decreased
T. catabolism is regulated by lipase, epinephrine and cortisol.
Transported by chylomicrons and VLDL

Cholesterol

Found only in Animals
Important component of membrane, steroid hormones, bile and Vit. D.
Dietary source
synthesized by the liver

Cholesterol

70% is associated with cellular components
30% is in the plasma (1/3 free form, 2/3 esterfied)
Transported by HDL and LDL

Phospholipids

Important components of cell membranes
Lecithin and sphingomyelin are utilized to determing fetal lung maturity and amniotic fluid (L/S ratio)

Glycolipids

Lipids with a carbohydrate component
ABO antigens are glycolipids

Apoliproproteins

*Outer protein shell of lipoprotein
*The lipid protein interactions allows the water insoluble lipid to become soluble in plasma.
*Responsible for the interactions with cell membranes and enzymes to transport lipids to specific locations.

HDL composition

30% Phospholipids
20% Cholesterol
50% Apoprotein

What major protein found in HDL?

Apo - A1 HDL

What Apolipoprotein is associated with high risk of CVD?

Apo - B LDL

What Apolipoprotein is associated with chylomicron remnants and renal failure?

Apo - C

Activates lipoprotein lipase?

Apo - C2

The exogenous pathway involves primarily which lipoprotein?

Chylomicrons

Chylomicron emnants are catabolized and channeled in what three pathways?

Synthesized VLDL, Released to form bile acids, Stored as cholesterol ester.

Lipoprotein physiology and metabolism

*Water insoluble lipids are digested into more water soluble.
*Triglycerides are digested into fatty acids.
*Cholesterol esters are converted into free cholesterol
*Fatty acids are converted into triglycerides by the liver and adipose tissue.

Lipoprotein physiology and metabolism

Most cholesterol synthesis occurs int the liver.
Most cholesterol lowerin drugs target this synthesis.
Cholesterol is a main component of bile (needed for dietary absorption of fat)

Exogenous Pathway

Transport of dietary lipids, mostly tge chylomicrons transportation of triglycerides to the liver.

Endogenous Pathway

Transportation of lipids from the liver to the tissues VLDL and LDL

Effects of Hormones (Insulin)

Decreases plasma glucose
Inactivates lipase which dec lipolysis and the catabolism of trigs to fatty acids/ glucose.
Stimulates lipogenesis (FA to Trigs)
Helps make fat

Hyperlipidemia

Standing plasma test for chylomicrons:
Plasma at 4C overnight
*Chylomicrons accumulate as floating cream layer.
*Chlyomicrons in fasting plasma are abnormal.

Normal Target Ranges

Total Cholesterol - < 200 mg/dl
HDL - > 35 mg/dl
LDL - < 130 mg/dl

Reference Ranges

T. cholesterol - 140-200 mg/dl
HDL - 30 - 75 mg/dl
LDL - 55-130 mg/dl
Trigs - 65- 155 mg/dl

Functions of Apolipoproteins

Activate enzymes involved in lipid metabolism (LCAT, LPL).
Maintain structural integrity of lipid/protein complex.
Delivery of lipids to cells via reognition of cell surface receptors.

Dyslipoprteinemias

Secondary or primary causes.
Secondary causes include starvation, liver disease, renal failure, diabetes, hypothyroidism, lipodystrophies, and drugs. Primary causes Inc. production, Defective processing, Defective cellular uptake, and inadequate removal.

Dyslipoproteinemias

Hyperchylomicronemia:
LPL deficiency
Apo C - II deficiency

High Cholesterol / High LDL

Diet / lifestyle
Secondary to hypothyroidism or nephrotic syndrome
(disruption of Apo - B metabolism)
Polygenic: (means we dont know)
Familial hypercholesterolemia
Familial defective Apo-B
Rare disorders

High TG / Normal Cholesterol

Diet / lifestyle
Secondary to diabetes, thiazide diuretics, Cushions, beta blockers, CRF/ nephrotic syndrome.
Familial hypertriglyceridemia
APo C III excess (interferes with LPL)
LPL deficiency
APo C II deficiency

High cholesterol / TG

Obesity
Secondary to steroids, Cs, hypothyroidism, CRF.
Familial combined hyperlipidemia.
Perioxisome proliferator activator receptor.
Dysbetalipoproteinemia (type III)
Hepatic lipase deficiency ( rare)

Low cholesterol / Low- Normal HDL

Abeta lipoproteinemia - APO B degraded after synthesis causes fat malabsorption.
Hypobetaproteinemia - genetically defective Apo B.
Chylomicron retention disease.

High HDL

Lifestyle (Ethanol)
Secondary to phenytoin, phenpbarbitol, rifampicin and estrogens.
Cholesteryl Ester Transfer Protein defects

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set