[Diagnosis of primary hyperlipoproteinemia during a preventive examination]

The study analyses the occurrence and etiology of hyperlipoproteinemia (HLP) in healthy middle-aged probands who participated in a preventive examination. Frequency of HLP was 35%. After a 2-month low-cholesterol-diet, a control biochemical examination was done. The concentration of serum triglycerides decreased significantly (3.02 +/- 1.47, 2.02 +/- 1.14, p < 0.05, respectively). The occurrence of type IV HLP decreased from 51.6% to 24.4% (p < 0.003). For the analysis of etiology of HLP we divided the hyperlipemic probands on the basis of presence of normolipemy (I. group), or HLP (II. group) in the control, and compared the lipid levels between them. We found out that the cholesterol levels in the II. group were significantly higher than in the I. group already before the diet-period (7.0 +/- 0.87 mmol/l, 5.85 +/- 0.81 respectively, p < 0.001), although the both groups did not differ in the triglyceride levels. Genetic examination in families revealed familial combined HLP in 24.4%, primary hypercholesterolemia in 12%, familial hypertriglyceridemia in 2% polygenic hypertriglyceridemia in 18%. We found out not only very high incidence of HLP in a sample of Slovak population but also that the most cases have the genetic background. The most frequent type of HLP was type IV. Since the triglyceride levels give poor information about the coronary risk, we recommend to examine the HDL-cholesterol already in the screening preventive programs.