Pathogenesis of hyperlipoproteinemia.

In the past 25 years, great advances have been made in our understanding of lipoprotein metabolism and of the causation of hyperlipidemia. These advances have been due in part to the study of patients with unusual defects in lipoprotein metabolism. Follow-up investigations into the specific metabolic defects in these patients have revealed qualitative abnormalities in the structure and function of apolipoproteins, the lipolytic system, and cell-surface receptors for lipoproteins. The development of isotopic tracer techniques, particularly multicompartmental analysis, has facilitated the elucidation of quantitative defects of lipoprotein transport responsible for other dyslipoproteinemias. In the last few years, it has been possible to integrate these discoveries and to create a more cohesive picture of the complex system of plasma lipid transport and of the abnormalities that can occur within it.