The clinical laboratory and hyperlipidemia: a clinician's view

Many patients with hyperlipidemia are without symptoms, thus laboratory data are often the sole index of therapeutic success or failure. Aggressive laboratory investigation of patient and family may identify inherited hyperlipidemia long before the clinical manifestations of atherosclerosis. The classification system of Fredrickson et al and Goldstein et al are reviewed from an historical and a clinician's point of view. Specific phenotypes and phenocopies, their causes, clinical manifestations, and management are presented. The basic laboratory assessment of hyperlipidemia is described, specialized testing is reviewed, and promising new methodologies are discussed.