Hyperlipoproteinemia. Prevalence in a free-living population in Albany, New York.

SUMMARY The prevalence of five types of hyperlipoproteinemia identified by Fredrickson, Levy, and Lees has been identified in 1301 male and female blood donors, aged 18-64 years. No patients with type I or V hyperlipoproteinemia were encountered, and only three patients with type III hy-perlipoproteinemia were discovered. Type IV hyperlipoproteinemia was the most prevalent disorder in this population and was significantly more prevalent in males than females-261/1000 vs 81/1000, respectively. The prevalence rate of type II hyperlipoproteinemia in male and female subjects was 87/1000 and 104/1000, respectively. Subjects with type IV, but not those with type II hyperlipoproteinemia, were significantly more obese than normal. High-density lipoproteiri levels were lower than normal in patients with type IV and with type II hyperlipoproteinemia irrespective of sex, while in normal subjects high-density lipoproteins were significantly higher in females. Densitometry of stained electrophoretically separated lipoproteins correlated highly with lipid content of these fractions but was not considered sufficiently accurate for use as a quantitative technic. A CORRELATION between elevated serum cholesterol and triglyceride levels and the prevalence and incidence of ischemic heart dis-ease'-5 has been established. It has been emphasized , however, that since these two lipids along with phospholipids are transported in blood as integral parts of lipoproteins, it is most rational to relate disordered lipid metabolism to coronary atherosclerosis in terms of serum lipoprotein levels.5 This approach was advocated with little acceptance almost 20 years ago6 and has been validated only recently since it was demonstrated by Fredrickson, Levy, and Lees7-11 that a variety of hyperlipopro-teinemic states exists, each with its characteristic clinical and biochemical features and each requiring a particular form of therapy. Although the association of one of these disorders, namely type II hyperlipoproteinemia (familial hypercholesterol-558 Lipoproteins Coronary artery disease emia) with premature coronary atherosclerosis has long been recognized in clinical practice and more recently from epidemiologic studies,12 the relationship of other types, i.e. I, III, IV, and V, to this disease is less well defined since there have been no prospective studies of populations in which these hyperlipoproteinemias have been identified. While early prospective studies from the Albany Cardio-vascular Health Center which reported on the significance of elevated triglyceride levels4 did not include lipoprotein typing, subsequent studies'3 revealed that elevated triglyceride levels in these subjects represented elevated very low-density lipoproteins. It would appear likely, therefore, that the increased prevalence and incidence of ischemic heart disease in these subjects with …