Efficacy of a simplified primary screening procedure for detection of hyperlipoproteinemias in a pediatric population.

We examined the efficacy of a simple primary screening procedure for detecting beta- and pre-beta-lipoprotein abnormalities in 3183 children, ages 5-14, residing in Bogalusa, Louisiana. This procedure is based on the ability of beta- and pre-beta-lipoproteins to form insoluble complexes with heparin in the presence of Ca2+; the turbidity produced by the reaction was considered as an index of the concentration of these two classes of lipoproteins. Our results indicate a close relationship (r = 0.88) between the beta- + pre-beta-lipoprotein index (turbidity) and the concentrations of these lipoproteins. Comparison of serum lipid and beta- + pre-beta-lipoprotein values of 5% of the children whose results fell outside the normal limits (upper and lower 5%) indicated that serum total cholesterol was not reflecting the beta- + pre-beta-lipoprotein concentration of a given child. The variability of alpha-lipoprotein concentration in these children accounted for this discrepancy. Measuring the serum beta- + pre-beta-lipoprotein index may be more useful for large-scale screening and for detecting subtle abnormalities than are determinations of either cholesterol or triglycerides.