Display options
Share it on

Arch Med Sci. 2019 Aug 03;16(6):1279-1287. doi: 10.5114/aoms.2019.86964. eCollection 2020.

Modern prevalence of the Fredrickson-Levy-Lees dyslipidemias: findings from the Very Large Database of Lipids and National Health and Nutrition Examination Survey.

Archives of medical science : AMS

Vasanth Sathiyakumar, Vincent A Pallazola, Jihwan Park, Rachit M Vakil, Peter P Toth, Mariana Lazo-Elizondo, Renato Quispe, Eliseo Guallar, Maciej Banach, Roger S Blumenthal, Steven R Jones, Seth S Martin

Affiliations

  1. Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
  3. Department of Medicine, Community Hospital General Medical Center, Sterling, IL, USA.
  4. Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
  5. Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.

PMID: 33224326 PMCID: PMC7667447 DOI: 10.5114/aoms.2019.86964

Abstract

INTRODUCTION: Five decades ago, Fredrickson, Levy, and Lees (FLL) qualitatively characterized clinical dyslipidemias with specific implications for cardiovascular and non-cardiovascular morbidity and mortality. They separated disorders of elevated cholesterol and triglycerides into five phenotypes (types I-V) based on their lipoprotein profile. Although clinicians generally consider them rare entities, modern FLL prevalence may be greater than previously reported.

MATERIAL AND METHODS: We performed a cross-sectional analysis in 5,272 participants from the 2011-2014 National Health and Nutrition Examination Survey and 128,506 participants from the Very Large Database of Lipids study with complete, fasting lipid profiles. We used a validated algorithm to define FLL phenotypes employing apolipoprotein B, total cholesterol, and triglycerides.

RESULTS: Overall prevalence of FLL phenotypes was 33.9%. FLL prevalence in the general population versus clinical lipid database was: type I (0.05 vs. 0.02%), type IIa (3.2 vs. 3.9%), type IIb (8.0 vs. 10.3%), type III (2.0 vs. 1.7%), type IV (20.5 vs. 24.1%), and type V (0.15 vs. 0.13%). Those aged 40-74 years had a higher overall prevalence compared to other age groups (

CONCLUSIONS: FLL phenotypes are likely far more prevalent than appreciated in clinical practice, in part due to diabetes and obesity epidemics. Given the prognostic and therapeutic importance of these phenotypes, their identification becomes increasingly important in the era of precision medicine.

Copyright: © 2019 Termedia & Banach.

Keywords: National Health and Nutrition Examination Survey; Very Large Database of Lipids; apolipoprotein B; hyperlipoproteinemia; prevalence

Conflict of interest statement

VS, VAP, JP, RMV, MLE, RQ, EG, MB, and RSB have no relevant disclosures. PPT: Speakers Bureau; Amarin, Akcea, Amgen, Kowa, Merck, Nova Nordisk, Regeneron, Sanofi (Consultant/Advisory Board). SRJ: Co-i

References

  1. Circulation. 2002 Dec 17;106(25):3143-421 - PubMed
  2. BMC Infect Dis. 2005 Jun 14;5:47 - PubMed
  3. Curr Atheroscler Rep. 2012 Feb;14(1):1-10 - PubMed
  4. Arch Med Sci. 2019 May;15(3):598-606 - PubMed
  5. Circulation. 1999 Jun 8;99(22):2852-4 - PubMed
  6. J Clin Invest. 1979 Jun;63(6):1274-83 - PubMed
  7. Circulation. 2011 May 24;123(20):2292-333 - PubMed
  8. Bull World Health Organ. 1970;43(6):891-915 - PubMed
  9. Circulation. 1972 Jan;45(1):114-26 - PubMed
  10. Nat Rev Endocrinol. 2010 Jun;6(6):335-46 - PubMed
  11. Circulation. 2000 Oct 17;102(16):1886-92 - PubMed
  12. Arch Med Sci. 2017 Feb 1;13(1):1-45 - PubMed
  13. JAMA. 2015 Sep 8;314(10):1021-9 - PubMed
  14. Circulation. 1975 Feb;51(2):209-11 - PubMed
  15. Atherosclerosis. 1996 Dec 20;127(2):273-82 - PubMed
  16. Eur J Clin Invest. 2011 Apr;41(4):423-33 - PubMed
  17. Clin Cardiol. 2016 Sep;39(9):491-6 - PubMed
  18. Circulation. 1993 Dec;88(6):2762-70 - PubMed
  19. Can Med Assoc J. 1980 Jan 12;122(1):37-8, 40-6 - PubMed
  20. J Chronic Dis. 1973 Apr;26(4):227-36 - PubMed
  21. Circulation. 2016 Mar 15;133(11):1067-72 - PubMed
  22. Med Sci Monit. 2014 Dec 16;20:2683-8 - PubMed
  23. N Engl J Med. 2015 Jul 30;373(5):438-47 - PubMed
  24. J Clin Lipidol. 2014 Nov-Dec;8(6):594-605 - PubMed
  25. N Engl J Med. 1967 Jan 26;276(4):215-25 contd - PubMed
  26. Eur J Hum Genet. 2009 May;17(5):541-2 - PubMed
  27. Eur Heart J. 2016 Oct 14;37(39):2999-3058 - PubMed
  28. Clin Cardiol. 2013 Nov;36(11):641-8 - PubMed
  29. N Engl J Med. 2014 Dec 4;371(23):2200-6 - PubMed
  30. JAMA. 2013 Nov 20;310(19):2061-8 - PubMed
  31. J Clin Invest. 1986 Feb;77(2):520-7 - PubMed
  32. Curr Cardiol Rep. 2016 Jul;18(7):65 - PubMed
  33. N Engl J Med. 2017 Jul 20;377(3):222-232 - PubMed
  34. J Am Coll Cardiol. 2019 Jun 25;73(24):3168-3209 - PubMed
  35. Curr Atheroscler Rep. 2014 Sep;16(9):440 - PubMed
  36. Eur J Epidemiol. 1992 May;8 Suppl 1:92-8 - PubMed
  37. Circulation. 1965 Mar;31:321-7 - PubMed
  38. Diabetologia. 2015 May;58(5):886-99 - PubMed
  39. J Am Coll Cardiol. 2016 Jun 7;67(22):2578-89 - PubMed

Publication Types