Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A monoclonal antibody-based direct binding enzyme-linked immunosorbent assay (ELISA) for apoprotein (apo) B-100 has been developed for use as a reference method. The assay uses the two well-characterized monoclonal antibodies, MB24 and MB47. MB47, which recognizes an epitope at the low density lipoprotein (LDL) receptor-binding domain of apoB and is specific for apoB-100, is bound to the microtiter plate as the capture antibody. MB24, which binds an epitope in the amino terminal half of the apoB-100 and identifies both apoB-100 and apoB-48, is conjugated to horseradish peroxidase and is utilized as the indicating antibody. The assay was calibrated with LDL (d 1.030-1.050 g/ml) and the LDL protein was determined by a sodium dodecyl sulfate (SDS) Lowry procedure. The working range of the assay is 0.25-1.25 micrograms/ml. Optimal dilution of whole plasma was found to be 1:2000. In the assay, MB47 bound approximately 97% of the apoB in all low density lipoprotein, and greater than 90% of the apoB in the majority of very low density lipoprotein preparations. Small dense LDL from subjects with familial combined hyperlipidemia (FCHL) and large bouyant LDL from subjects with familial hypercholesterolemia (FH) exhibited binding properties similar to LDL from healthy normolipidemic subjects when tested in the reference ELISA. The intra- and interassay coefficients of variation averaged 2.5% and 6.0%, respectively. Plasma B-100 levels were not influenced by freezing and thawing or storage at 4 degrees C for up to 3 weeks or storage at -70 degrees C for up to 11 months. Excellent agreement was obtained between the reference ELISA and a polyclonal RIA which measures total apoB (r = 0.93, n = 105, mean ELISA B-100 value = 100 mg/dl, mean RIA value = 101 mg/dl, Sy = 9.6). Reference ELISA B-100 values of samples pretreated with bacterial lipase were not significantly increased in most samples with plasma triglyceride levels below 600 mg/dl. To help reduce the large among-laboratories variability of apoB measurements, we recommend that this candidate reference direct binding ELISA be used to assign apoB target values to apoB reference pools.
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PMID:Evaluation of a monoclonal antibody-based enzyme-linked immunosorbent assay as a candidate reference method for the measurement of apolipoprotein B-100. 260 May 45

Pseudohyponatremia is a falsely low serum sodium measurement. It occurs in cases of extreme hyperlipidemia or hyperproteinemia when serum sodium is measured by some--but not all--laboratory methods. This article reviews the most common techniques for measuring serum sodium levels, explains why pseudohyponatremia occurs, and identifies specific situations in which pseudohyponatremia can lead to dangerous errors in patient management. The review describes the dramatic change in prevalence of the different laboratory methods for measuring serum sodium over the past decade, and emphasizes the need for clinicians to be familiar with the methods of their clinical laboratory in order to properly interpret a reported serum sodium determination. I offer recommendations for the rational use of the different laboratory methods in various clinical situations.
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PMID:Pseudohyponatremia: a reappraisal. 264 73

The serum sodium concentration reflects the osmolality of the extracellular fluid and provides no direct information about total body sodium content. Patients with hyponatremia may have decreased, normal, or increased total body sodium content. The first step in the approach to the patient with hyponatremia is measurement of plasma osmolality. Hyponatremia with normal plasma osmolality results from hyperlipemia or hyperproteinemia whereas hyponatremia with increased plasma osmolality results from hyperglycemia or mannitol infusion. Patients with hyponatremia and decreased plasma osmolality may be hypovolemic, hypervolemic, or normovolemic. The volume status of the patient is best determined by history, physical examination, and a few ancillary tests (e.g., total plasma protein concentration, hematocrit, blood pressure, central venous pressure). The clinical signs of hyponatremia are related more to the rapidity of onset than to the severity of the associated plasma hypoosmolality and reflect influx of water into the central nervous system. The main goals of treatment in hyponatremia are to manage the underlying disease and, if necessary, to increase serum sodium concentration and plasma osmolality.
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PMID:Hyponatremia. 264 63

Diabetic lipemia with and without acute pancreatitis in chronic alcoholism. A report of 4 cases. Diabetic lipemia was observed in 4 chronic alcoholic men after ingestion of high doses of alcohol and/or sugar-rich beverages, including one patient who was treated for insulin-dependent diabetes. None had a previous history of serum lipid disturbances. All had marked hyperglycemia, hyperosmolality and hypertriglyceridemia (mean: 60.8 mmol/l), 2 of undetermined type and 2 of type IV with eruptive xanthomas. Factitious hyponatremia was present in 3 cases, but true serum sodium was normal (138 mmol/l) or elevated (154, 156, 182 mmol/l) after correction. Three patients developed acute pancreatitis ascribed to high serum triglyceride levels and/or to alcohol ingestion. Serum and urine amylase activity was inhibited by hypertriglyceridemia. The diagnosis of pancreatitis was assessed twice by echography and computed tomographic scan, and once by tomographic scan and an elevation of the amylase on creatinine clearance ratio. It is likely that hypertriglyceridemia predisposed these patients to develop pancreatitis, alcoholism being a precipitating factor. We suggest that the diagnosis of acute pancreatitis should be systematically considered in any case of diabetic lipemia without true hyponatremia.
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PMID:[Diabetic hyperlipemia with or without acute pancreatitis in patients with chronic alcoholism. A study of 4 cases]. 274 Jun 61

To summarize, patients with the "beer potomania" syndrome are characterized by 1) a history of chronic alcohol ingestion (in a hypotonic form); 2) protein malnutrition; 3) signs, symptoms and laboratory values consistent with water intoxication, including hyponatraemia, hypochloraemia and, usually, hypokalaemia; 4) no evidence of another cause of hyponatraemia such as steroid use, diuretic use, hyperlipidaemia, etc. The pathophysiology involves the inability to excrete sufficient free water, based on a loss of normal renal urea gradients. Patients may actually be total-body sodium depleted, yet have elevated urinary sodium and fractional sodium excretion due to this disorder of water metabolism. Attention to proper nutrition during the acute illness may obviate the need for potentially hazardous administration of hypertonic saline.
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PMID:Beer potomania syndrome in an alcoholic. 276 35

This is a kinetic assay for measuring serum Na+ concentration based on determination of Na+-dependent beta-galactosidase (EC 3.2.1.23) activity. The method, sufficiently sensitive to measure sub-millimolar concentrations of Na+, was modified by including a Na+-binding agent (cryptand) to provide a linear assay for serum Na+ concentrations between 110 and 160 mmol/L. The assay was developed with and evaluated in the Cobas Fara centrifugal analyzer (and has been used in other kinetic analyzers). Within-run and between-run CVs were less than 1%. The reaction rate for normal serum samples (0.20 delta A/min) is about 10-fold that of the reagent blank. Results correlated well with flame photometry. Interference from bilirubin, hemoglobin, lipemia, heparin, and other cations was negligible. The method offers a practical alternative to the use of ion-selective electrodes and flame photometry for measuring serum Na+ in high-throughput or "stat" biochemical analyzers.
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PMID:Enzymatic determination of sodium in serum. 314 Oct 85

Modern views of the pathogenesis and natural history of nephrotic syndrome have changed substantially since the early studies by Cotugno and Bright. Contrary to beliefs held 20 years ago, we do not possess a unique satisfying explanation for the induction, maintenance, and resolution of nephrotic edema, and many concepts firmly established as "classic" are now being revised or reconsidered. These include the relationship between urinary protein losses and hypoalbuminemia, which is complicated by several factors such as daily protein intake, albumin catabolism, and the possible role of albumin loss at extrarenal sites. The influence of lowered plasma albumin on the decrease in plasma volume is also quite complex, due to technical difficulties in measuring plasma volume and turnover of radio-labeled albumin. The most contentious areas are how sodium and water retention are initiated and maintained and the relationship between hypoalbuminemia, plasma oncotic pressure, and edema. While aldosterone excretion and plasma concentrations are elevated in nephrotic patients, data on the renin-angiotensin system are controversial and the renal handling of sodium is related to a host of factors including glomerular filtration rate, altered proximal tubular reabsorption, and the role of vasodilators or vasoconstrictors. The complications of nephrotic syndrome are protean and relatively common. Among those are acute renal failure, thrombosis, infections, and hyperlipidemia. Since the introduction of percutaneous biopsy, the spectrum of lesions underlying nephrotic syndrome has widened considerably, the most common being minimal change, especially in children. There are very few prognostic indicators by which response to treatment may be predicted and these include persistent microscopic hematuria.
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PMID:The nephrotic syndrome and its complications. 330 94

Dietary factors ingested in excess, deficient, or in imbalance have been implicated in the etiology, and corrected in the management of cardiovascular diseases, namely atherosclerosis and hypertension. Dietary factors include: calories; fats; cholesterol and other sterols; complex and simple carbohydrates; animal and vegetable protein; alcohol; and minerals. Atherogenesis from diets high in total and saturated fat and cholesterol may relate to increases in plasma total, low- or very low-density lipoprotein cholesterol or triglycerides, or decrease in high density lipoprotein cholesterol, or altered apolipoproteins. A variety of dietary manipulations can influence these lipid and lipoprotein levels and thereby reduce cardiovascular risk. Plasma lipid and lipoprotein levels in the population vary with age, gender, and race; cardiovascular risk is increased when cholesterol levels exceed the 75th or 90th percentile for healthy men and women for age. Abnormally high levels of plasma cholesterol or triglycerides in different lipoprotein carriers comprise the various hyperlipoproteinemias. The clinical presentations and dietary management of elevated LDL cholesterol, and/or VLDL/ and/or chylomicron triglycerides, or increased intermediate density lipoproteins are reviewed and discussed. Attention should be paid to family screening, and hyperlipidemias secondary to diseases or medication should be considered. Dietary counseling and management is advised for children at risk of hyperlipidemia and for adult patients up to 70 years of age. If lipids and lipoproteins are not normalized, then lipid-lowering drug therapy should be considered in adults. For control of hypertension, attention should be paid to calories and alcohol, and to calcium, potassium, and sodium.
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PMID:Why, what, and how to implement reduction of cardiovascular risk factors by diet. 332 Jan 54

We evaluated the IL Monarch random-access centrifugal analyzer for measurement of Na+, K+, and Cl- by an indirect potentiometric method. For different concentrations of control material, the total precision (CV) ranged between 0.82% and 1.14% for the three electrolytes; linearity was acceptable within a range of 103 to 215 mmol/L for Na+, 1.6-15.25 mmol/L for K+, and 80-173 mmol/L for Cl-. Data correlated well with those by flame photometry for Na+ and K+ and with those by coulometry for Cl-, both for various biological materials--sera, urines, dialysis fluids--and commercial control materials from various producers. Stability of the potentiometric signal was acceptable: daily variations were 0.2 mV for Na+, 0.05 mV for K+, and 0.03 mV for Cl-. Accordingly, we conclude that the system supplies reproducible and accurate results while being easy to use and requiring little maintenance. The use of indirect potentiometry offers results consistent with those obtained with traditional methods, and easily interpretable by clinical staff. However, better information about the actual ion activity in the tested sample for certain pathologies such as hyperlipemia and dysproteinemia could be obtained by methods involving direct potentiometry.
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PMID:Reliability of IL Monarch ion-selective electrode module for sodium, potassium, and chloride measurements. 335 13

The glomerulus is a complex structure containing a remarkable capillary bed which is freely permeable to water and solutes up to the size of inulin. Many small proteins are filtered, reabsorbed, and catabolized by the kidney; but most large proteins, such as albumin or immunoglobulins, are almost entirely excluded from the glomerular ultrafiltrate due to the charge-size permselectivity of the glomerular capillary basement membrane. These large proteins appear in the urine when diseases reduce the charge selectivity or result in the development of large pores in this membrane. The reabsorptive capacity of the renal tubules for these proteins is overwhelmed. Hypoalbuminemia results when increased synthetic and decreased catabolic rates of albumin fail to compensate for the urinary loss of the protein. The resulting decrease in serum oncotic pressure increases the flux of fluid out of systemic capillaries into the interstitial space, a process that increases lymphatic flow and returns the relatively protein-poor ultrafiltrate to the plasma compartment. Interstitial proteins are swept into the plasma by the increased lymphatic flow, leading to a depletion of the extravascular pool of albumin even more severe than the depletion of albumin in the plasma compartment. The rate of albumin synthesis is increased but not sufficiently to replace losses and restore the serum concentration to normal. The rate of albumin catabolism is decreased. This decrease from the normal catabolic rate is as important as the increased rate of albumin synthesis in maintenance of albumin homeostasis in nephrosis. Whereas the reduced serum oncotic pressure certainly contributes to edema formation, sodium retention may result from processes intrinsic to the kidney itself; and plasma volume may actually be expanded despite hypoalbuminemia. The hyperlipemia that occurs in nephrosis is due to a combined defect in lipoprotein metabolism: increased hepatic synthesis of VLDL and decreased removal of TG and highly atherogenic remnants of incompletely metabolized CMs. The defects in lipoprotein metabolism may in part be the end result of the urinary loss of highly negative-charged macromolecules of the mucopolysaccharide called orosomucoid, which carries with it heparan sulfate, and important cofactor for LPL.
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PMID:Mechanisms and consequences of proteinuria. 351 85


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