Secondary HLPs. During recent years, several studies (6775) investigated the application of the Friedewald formula in patients with secondary HLPs.
Electrophoresis is considered the definitive method for detecting the characteristic broad [beta] band in patients with type III HLP. However, compared with the highly automated instruments used for enzymatic and immunochemical assays, electrophoresis is somewhat labor-intensive and technique-sensitive and thus is of more interest to the specialty laboratory than to the high-volume routine laboratory.
Type III HLP or dysbetalipoproteinemia, characterized by accumulation of remnant lipoproteins with an increased proportion of cholesterol relative to TGs, also precludes reliable calculation.
Only 0.4% were misclassified two medical decision points high, and all of those had type III HLP (60).
With TGs of 2000-4000 mg/L, the reliability is considered acceptable in most cases but may be compromised, which is of special concern, in patients with secondary HLP. For individuals with TGs >4000 mg/L, chylomicrons, or type III HLP, the use of the Friedewald equation for LDL-C estimation is not considered valid.
Recently, the coprecipitation of VLDL remnants by dextran sulfate was exploited in a screening test for type III HLP (90).
Type III HLP gave results equivalent to (45) or lower than (83, 91) those obtained by BQ.
Using case studies of four interns in their final semester of their student teaching internship, we show how their HLP
use is evidenced across these conceptions of authenticity.