Determination Of Serum Triglycerides,
Cholesterol
By: Assist. Lecturer
Sazgar A. Hameed
MSc. in Clinical Biochemistry
College of Medicine – HMU
Email:
[email protected] Introduction:
Lipids are a heterogeneous group of water-insoluble
organic molecules that can be extracted from
tissues by non polar solvents.
The lipids of metabolic importance in human body
are TGs, phospholipids, cholesterol ester and their
products of metabolism such as glycerol, FFA,
cholesterol, ketone bodies, etc.
Introduction, cont.
Triglyceride is a glycerides in which the glycerol
is esterified with three fatty acids.
It is the main constituent of vegetable oil and
animal fats.
TGs play an important role in metabolism as
energy sources and transporters of dietary fat.
Cholesterol is a waxy steroid metabolite found in
the cell membranes and transported in the
blood plasma of all animals.
Introduction, cont.
Cholesterol is an important component for the
manufacture of bile acids, steroid hormones, and
several fat soluble vitamins.
Cholesterol is synthesized in most body tissues
including, liver, adrenal cortex, brain and skeletal
muscle.
Cholesterol is present in tissues and in plasma
either as free cholesterol or as cholesteryl ester,
most plasma cholesterol is in an esterified form.
Normal Ranges:
TG <160mg/dl
Cholesterol < 200mg/dl
Diagnostic Application:
Serum TGs, and cholesterol are correlated with the
incidence of atherosclerosis, coronary heart disease,
and myocardial infarction.
Clinical Significance:
A- Hyperlipidemia:
i- Hypertriglyceridemia: may be primary or secondary.
1- Primary or familial hypertriglyceridemia, may be due to
decreased catabolism of VLDL, or chylomicronemia which result
from LPL deficiency, or both.
2- Secondary hypertriglyceridemia: obesity, DM, kidney
diseases (nephrotic syndrome, and renal failure),
hypothyroidism, and excessive alcohol intake.
ii- Hypercholesterolemia:
1- Familial hypercholesterolemia: result from one or several
mutations in the LDL receptor which located on the surface of
most body cells (LDL receptor deficiency).
Clinical Significance, cont.
2- Food that is high in saturated fat or cholesterol.
3- Obesity.
4- Excessive alcohol intake.
5- Certain diseases:
a. Atherosclerosis
b. DM
c. Nephrotic Syndrome
d. Obstructive Jaundice
e. Hypothyroidism
B- Hypolipidemia: decreased level of TG, and
Cholesterol in serum is seen in the following cases:
1- Rare genetic conditions such as A beta lipoproteinemia
and hypobetalipoproteinemia: the disorder is due to
deficiency of an apolipoprotein called apo β which result
in absence of chylomicron, VLDL, LDL, and low plasma TG
and cholesterol.
2- Malnutrition, malabsorption, and starvation.
3- Liver disease like sever hepatitis.
4- Hyperthyroidism.
Lipoproteins:
Lipoprotein is a complex molecule which is
composed of protein, cholesterol, and triglycerides.
They are mainly responsible for transport of lipid
and they circulates in blood.
The specific proteins that binds with lipids are
called apolipoproteins.
There are a variety of apolipoproteins, Apo A,
Apo B, Apo C, Apo E, and a minor fraction Apo D.
Lipoproteins, cont.
The lipoproteins are classified into five major
classes, they are:
a-Chylomicrons
b- Very low density lipoproteins(VLDL)
c- Low density lipoproteins(LDL)
d- Intermediate density lipoproteins(IDL)
e- High density lipoproteins(HDL).
Principle:
A- TG
TG Lipase Glycerol + FFAs
Glycerol + ATP GK Glycerol-3-p + ADP
Glycerol-3-p + O2 GPO Dihydroxy acetone-P + H2O2
H2O2 + 4-Chlorophenol + PAP POD Quinoneimine + H2O
B- Cholesterol
Cholesterol esters CE Cholesterol + FFAs
Cholesterol + O2 CO Cholesten-4-one-3 + H2O2
2H2O2 + Phenol +PAP POD Quinoneimine + 4H2O
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