Analysis of the three major classification methods for hyperlipidemia: WHO, etiology, and clinical classification.
It is advisable to understand the classification methods of hyperlipidemia: Because different types of lipid metabolism processes differ, the mechanisms of hyperlipidemia and the fluctuations in blood lipoproteins vary greatly. This classification method greatly facilitates the prevention and treatment of hyperlipidemia. The following are three commonly used classification methods:
(1) Classification according to the World Health Organization (WHO) guidelines.
The WHO requires that, in addition to measuring blood lipid indicators, the lipoprotein electrophoresis pattern of fasting serum must also be measured. The degree of turbidity in the lipoprotein electrophoresis pattern is observed to classify it into 5 types:
Type I: Elevated chylomicrons (CM), significantly elevated triglycerides (TG), slightly elevated total cholesterol (TC), only very low-density lipoprotein cholesterol (VLDL-C) is normal.
Type IIa: Cholesterol > 5.7 mmol/L, elevated low-density lipoprotein cholesterol (LDL-C).
Type IIb: In addition to elevated TC and LDL-C, elevated VLDL-C is also present.
Type III: Both TC and TG are elevated. Type IV: TC/TG = 1, VLDL-C/TG > 0.3, with floating β-lipoprotein.
Type V: TG > 1.69 mmol/L, TC normal.
Type V: Elevated CM, VLDL-C/TG < 0.3, no floating β-lipoprotein.
Of the five types, Type IIa, Type IIb, and Type IV are the most common, while Type I is relatively rare.
(2) Classification by etiology.
According to the cause of hyperlipidemia, it is divided into primary and secondary types. Primary hyperlipidemia may be caused by genetic defects or acquired factors such as diet, lifestyle, and natural environment without other causes. For example, familial hypercholesterolemia (TC) caused by lipase deficiency, familial hypertriglyceridemia (TG) caused by low-density lipoprotein receptor deficiency, ordinary (polygenic) hypercholesterolemia (TC), apolipoprotein abnormalities, simple obesity, etc., all of these belong to primary hyperlipidemia. Secondary hyperlipidemia is caused by a specific underlying disease, such as hypothyroidism, lymphoma, nephrotic syndrome, diabetes, or alcoholism.
(3) Thematic Group Classification Method.
The Thematic Group on Prevention and Treatment of Dyslipidemia of the Editorial Board of the *Chinese Journal of Cardiovascular Diseases* classifies hyperlipidemia into four types:
Hypercholesterolemia: Elevated serum cholesterol levels.
Mixed hyperlipidemia: Elevated serum cholesterol (TC) and triglyceride (TG) levels.
Hypertriglyceridemia: Elevated serum triglyceride levels.
Low high-density lipoprotein cholesterol (HDL-C)emia: Decreased serum high-density lipoprotein cholesterol levels.
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