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Classification of Hyperlipidemias

For the purposes of diagnosis and treatment the most convenient classification is that which is based on the type of lipid abnormality (cholesterol, TG, or both).

1. Primary hyperlipidaemias


  • Familial
  • Polygenic


  • Familial lipoprotein lipase (LPL) deficiency
  • Familial apolipoprotein C-II deficiency
  • Familial hypertriglyceridaemia                        

Combined hypertriglyceridaemia and hypercholesterolaemia

  • Familial combined hyperlipidaemia
  • Familial type 3 hyperlipoproteinaemia
2. Secondary hyperlipidaemias 


  • Hypothyroidism
  • Obstructive jaundice
  • Acute porphyria
  • Growth hormone deficiency
  • Drugs: corticosteroids


  • Diabetes mellitus (DM)
  • Alcoholism
  • Lipodystrophies
  • Renal failure
  • Oestrogens (pregnancy,oral contraceptives)
  • Glycogen storage disease
  • Systemic lupus   erythematosis (SLE)
  • Obesity
  • Severe stress
  • Thiazides

Combined hypertriglyceridaemia and hypercholesterolaemia

  • Nephrotic syndrome
  • Myelomatosis
  • Diabetes mellitus (DM)
  • Renal failure
Fredrickson Classification

WHO (Fredrickson) classification of hyperlipidaemias, based on the electrophoeretic pattern of lipoproteins is as follows:

Types /Classification Seen on Electrophoresis Which Lipoprotein are increased Which Lipids increased
I Increased chylomicrons zone Chylomicrons Triglyceride
IIa Increased beta-lipoproteins zone LDL-c Cholesterol
IIb Increased pre-beta and beta lipoproteins zone VLDL and IDL-c Cholesterol and Triglyceride
III Beta band is broad in beta band zone IDL-c Cholesterol and Triglyceride
IV Increased pre-beta lipoprotein zone VLDL Triglyceride
V Increased pre-beta lipoprotein zone and chylomicrons zone VLDL and chylomicrons Cholesterol and Triglyceride

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