Type V hyperlipoproteinemia

Type V hyperlipoproteinemia requires stringent restriction of dietary fat intake. Drug therapy with fibrates or niacin is indicated if the response to diet alone is inadequate. Medium-chain triglycerides, which are absorbed without chylomicron formation, may be used as a dietary supplement for caloric intake if needed for both types I and V. 

People with severe hypertriglyceridemia associated with Type V hyperlipoproteinemia may be at increased risk of hypervitaminosis A, even with moderate degrees of vitamin A supplementation (1199). Long-term vitamin A administration is associated with an increase in serum cholesterol and serum triglyceride concentrations (1200) and consequently might be linked with atherosclerosis (SEDA-8, 345) (1201,1202). 

H. L. Verrill, R. E. Girgis, R. E. Easterling, B. S. Malhi, and W. F. Mueller, Distribution of cyclosporine in blood of a renal transplant recipient with type V hyperlipoproteinemia, Clin. Chem. 33 423-428 (1987). 

Apo C-II, the activator of lipoprotein lipase, was absent in a subject with severe hypertriglyceridemia a transfusion of plasma produced a temporary fall In the patient s circulating triglyceride, due to apo C-II in the normal donor s plasma. It was also reported that NA (12 g/day) Increased apo C-II in chylomicrons and VLDL of a subject with Type V hyperlipoproteinemia." These studies support the concept that low amounts of apo C-II may play a role in the development of hypertrigly-cerIdemia. 

Hyperapobeta- lipoproteinemia TAG T VLDL, LDL T Familial type V hyperlipoproteinemia CETP deficiency... 

Hyperlipoproteinemia, Type V. This pathology is manifested by increased con-tents of chylomicrons, pre-P-lipoproteins, triglycerides, and cholesterol in the patients blood plasma. 

Fic. 3. Protein components of human serum very high-density lipoprotein (VLDL) apoprotein (Apo). According to the experience gained in this laboratory, this component is negligible. As shown by Brown et al. (B9, BIO), it becomes relevant in VLDL of patients with types IV and V hyperlipoproteinemia,... 

The answer is a. (Hardman, pp 875-898.) In type I hyperlipoproteinemia, drugs that reduce levels of lipoproteins are not useful, but reduction of dietary sources of fat may help. Cholesterol levels are usually normal, but triglycerides are elevated. Maintenance of ideal body weight is recommended in all types of hyperlipidemia. Clofibrate effectively reduces the levels of VLDLs that are characteristic of types 111, IV, and V hyperlipoproteinemia administration of cholestyramine resin and lovastatin in conjunction with a low-cholesterol diet is regarded as effective therapy for type 11a, or primary, hyperbetalipoproteinemia, except in the homozygous familial form. 

H21. Hazzard, W. R., Wamick, G. R., Utermann, G., Albers, J. J., and Lewis, B., The complex genetics of Type III hyperlipoproteinemia Influence of co-inherited monogenic hyperlipidemia upon the phenotypic expression of apolipoprotein E3 deficiency. In Atherosclerosis V (A. M. Gotto, Jr., L. C. Smith, and B. Allen, eds.), pp. 260-263. Springer-Verlag, Berlin and New York, 1980. 

Ghiselh GC, Schaefer EJ, Gascon P, Brewer HB Jr (1981) Type III hyperlipoproteinemia associated with plasma apolipoprotein E deficiency. Science 214 1239-1241 Gualandri V, Franceschini G, Sirtori CR, Gianfranceschi G, Orsini GB, Cerrone A, Menotti A (1985) A-I Milano apoprotein. Identification of the complete kindred and evidence of a dominant genetic transmission. Am J Hum Genet 37 1083-1097... 

Carbohydrate-induced hyperlipemia (Ahrens et al. 1961), mixed hyperlipemia (Kuo and Bassett 1963), types III to V hyperlipoproteinemias (Fredrickson and Lees 1965), nonalimentary hyperlipemia (Kinsell and Schlierf 1965)]. 

They are useful only in hyperlipoproteinemias involving elevated levels of LDL i.e. type Ila, lib and V. They are basic ion exchange resins. They are neither digested nor absorbed in the gut. They bind bile acids in intestine and interrupt their entero-hepatic circulation, leading to increased faecal excretion of bile salts and cholesterol. There is increased hepatic conversion of choles-terol to bile acids. More LDL receptors are expressed on liver cells leading to increased clearance of IDL, LDL and indirectly of VLDL. 

---