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GANGGUAN METABOLISME LEMAKPemeriksaan 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
Hypertrigliseridemia ~ LDL small partikel > Meningkat pada chylomicron dan VLDL
Normo Hati-hati Resiko
< 200 mg/dL 200-300 mg/dL > 300 mg/dL
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 < 45 < 35 mg/dL
Pr > 45 < 35
LDL
Rumus Friedewald harus → TG<400 mg/dL Enzymatik (langsung)
LDL receptor
Normo Hati-hati Resiko
< 150 mg/dL 150-190 mg/dL > 190 mg/dL
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-3-
phosphate dehydrogenase (NAD+) 4 NAD+, triosephosphate isomere and
G3PH
Lain-lain
Total Protein Phospholipid Apoprotein B Apoprotein A Apoprotein E Lipoprotein A
Hiperlipidemia Familiar
TypePredom>
Lipoprotein
Predom >
LipidContoh
I Chylomicron Trigliserida LPL def.
IIa LDL Cholesterol Fa hyp-chol
IIb VLDL/LDL TG/Chol Fa com hyp
III Beta VLDL TG/Chol Tipe 3 hyp
IV VLDL TG Fa hyp TG
V Chylo/VLDL TG/Chol Apo CII def
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 smoking4. 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
