[New aspects of normolipidemic dyslipoproteinemias].

BACKGROUND

Normolipidemic dislipoproteinemias include various disorders of different lipoproteins, of their subfractions or some apolipo-proteins, of primary or secondary origin, which are widespread among general population and, like hyperlipoproteinemias, they are associated with the risk for premature atherosclerosis.

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It is a primary, familial hypoalphalipoproteinemia, which is commonly associated with obesity, diet rich in carbohydrates, decreased physical activity and excessive use of coffee and some drugs.

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It is characterized by increase of apo B-100 in LDL particles, most probably as a consequence of increased hepatic synthesis. Apolipoprotein E isoforms ApoE4 isoform is associated with elevated LDL-cholesterol concentration due to rapid IDL to LDL conversion.

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The most important is the latent type IV (pre-beta) or IVb (pre-beta1) with decreased VLDL clearance.

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It is common in obesity, NIDDM and coronary heart disease, as an independent risk factor for premature atherosclerosis.

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Oxidatively modified LDL may have a key role in the pathogenesis of atherosclerosis and oxidative modification of HDL reduces its transport capacity and its inhibition of LDL oxidation. INCREASED LEVEL OF LP(A) Lp(a) is an independent risk factor for premature atherosclerosis, primarily in young and middle-aged men, in persons with elevated global cardiovascular risk factor profile, decreased HDL-cholesterol, and hypertension. The risk is smaller in persons taking hypocholesterolemic drugs. Also, it is elevated in NIDDM, hypothyroidism and kidney disease.