Lipids in Clinical Chemistry
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39 terms
Terms | Definitions |
|---|---|
 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 |
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