We have developed a simple, rapid assay method for chylomicron and very low density lipoprotein (VLDL) remnants, using an immunoaffinity gel mixture of anti apo B-100 and apo A-I monoclonal antibodies coupled with Sepharose 4B. The standard assay contains 5μl of serum and 50μl of mixed gel, which adsorbs lipoproteins containing apo A-I quantitatively as well as most of the lipoproteins that contain apo B-100 (virtually all low density lipoprotein (LDL) and most VLDL). After 60 mins of shaking at room temperature, unbound cholesterol and triglyceride present in the supernatant are measured enzymatically. Unbound lipoproteins (RLP: remnant-like particles) are enriched in apo E, apo C and contain essentially all of the apo B-48 as well as some of the apo B-100 of the triglyceride-rich ipoproteins.The concentration of serum RLP-C was determined in the fasting state as follows: in 419 healthy normolipidemic subjects (male: 265, female: 154, age: 15-76) with a mean±SD of 2.1±1.6mg/dl. In 5% of the 419 healthy normolipidemic subjects and in 20.3% of the 454 normolipidemic patients (CAD, diabetes, etc.) the RLP-C concentration exceeded 5mg/dl.The levels of serum RLP-C among patients with hyperlipidemia. coronary artery disease, diabetes, obesity, fatty liver and chronic renal failure were shown to be high and over 40% of the patients exceeded 5mg/dl. Probucol was administered to the diabetic patients with relatively high RLP-C levels. After 2 months, RLP-C levels were decreased significantly by the probucol and remained at low levels.These results indicate that the quantification of serum RLP-C levels in a fasting state is a new, useful diagnostic marker for remnant hyperlipoproteinemia.
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Nakajima et al. (1992) studied this question.