GANGGUAN METABOLISME LEMAK

Pemeriksaan Laboratorium & Interpretasi

Prof. dr. Burhanuddin Nasution, SpPK-KN

Profile Lemak

Total

Cholesterol
Trygliserida
HDL
LDL

Total Cholesterol

Makin tua kadal cholesterol makin tinggi

Bad cholesterol dan good cholesterol
Total cholesterol meningkat ~ MCI, stroke & penyakit
periferal-vaskular
Rekomendasi

Hati-hati

Resiko

< 200 mg/dL

200-220 mg/dL

> 220 mg/dL

Total Cholesterol (mg/dL) / Umur

Umur

Pria

Wanita

10-14

165

165

15-19

159

165

20-29

180

180

30-39

205

190

40-49

215

210

50-59

215

220

Trigliserida

Normo

Hati-hati

Resiko

< 200 mg/dL

200-300 mg/dL

> 300 mg/dL

Hypertrigliseridemia ~ LDL small partikel >

Meningkat pada chylomicron dan VLDL

HDL
Lipoprotein

: kendaraan pengangkut lipids

dalam darah sel seluruh tubuh
Secara ultra centrifuge : HDL-1,HDL-2, HDL-3
Good Cholesterol
Normo

Hati-hati

Resiko

Lk > 55
Pr > 45

< 45
< 35

< 35 mg/dL

LDL
Rumus

Friedewald harus TG<400 mg/dL

Enzymatik (langsung)
Normo

Hati-hati

Resiko

< 150 mg/dL

150-190 mg/dL

> 190 mg/dL

LDL

receptor

Ultra Centrifuge/elektroforesis
Chylomicron
VLDL,

I-VLDL
HDL 1, 2 dan 3
LDL : dense particle LDL
low particle LDL

Pemeriksaan Cholesterol

Direct

procedures
Liebermann-Burchard
Extraction Procedures
Chop-pap

Pemeriksaan Trigliserida
1

Glycerol Dehydrogenase
2 Glycerol kinase couple with pyruvat
kinase and lactate dehydrogenase
3 Glycerol kinase and glycerol-3phosphate dehydrogenase (NAD+)
4 NAD+, triosephosphate isomere and
G3PH

Lain-lain
Total

Protein
Phospholipid
Apoprotein B
Apoprotein A
Apoprotein E
Lipoprotein A

Hiperlipidemia Familiar
Type

Predom>
Lipoprotein

Predom >
Lipid

Contoh

Chylomicron

Trigliserida

LPL def.

IIa

LDL

IIb

VLDL/LDL

TG/Chol

Fa com hyp

III

Beta VLDL

TG/Chol

Tipe 3 hyp

IV

VLDL

TG

Fa hyp TG

Chylo/VLDL

TG/Chol

Apo CII def

Cholesterol Fa hyp-chol

Risk Factors for CHD (NCEP 2001)

Positive :
1. Age (men 45 yr, women 55 yr)
2. Family history of premature CHD
(male parent or sibling < 55 yr, female
parent or sibling < 65 yr)
3. Current Cigarette smoking
4. Hypertension (BP 140/90 mmHg or
Receiving antihypertensive medication)
5. Low HDL C (< 40 mg/dL)
6. DM

Negative : 1. High HDL c ( 60 mg/dL)

Terima Kasih