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Karolina M Stepien, Commentary, Clinical Chemistry, Volume 61, Issue 8, 1 August 2015, Pages 1031–1032, https://doi.org/10.1373/clinchem.2014.236844
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This case report describes abnormal biochemical results in a patient with primary biliary cirrhosis (PBC). One of the extensive investigations carried out was of lipoprotein X, an abnormal lipoprotein in the serum of patients with obstructive jaundice (1). As shown in this case report, the presence of lipoprotein X affects cholesterol concentration. This patient had significantly raised bile acids—a hallmark of cholestasis—which have been shown to inhibit lipoprotein lipase, an enzyme participating in the degradation of lipoproteins.
An important characteristic feature of lipoprotein X is its mobility toward the cathode on agar-gel electrophoresis, which was also noted on this patient's lipoprotein electrophoresis. Another way of confirming that lipoprotein X is probably contributing to high total cholesterol concentration is the measurement of serum apolipoprotein B. Normal apolipoprotein B concentration along with high serum LDL cholesterol and high total cholesterol indicates the presence of another particle that is contributing to the raised concentrations of those lipids.
