Abstract
Familial dysbetalipoproteinemia (FD) is an autosomal recessive inherited (rarely dominant) disease that is caused by mutations or polymorphisms in the apolipoprotein E gene. The typical genotype is APOE2/E2, the phenotype is mixed dyslipidemia (DLP) manifesting in the context of other metabolic or genetic trigger factors.
It is a very atherogenic dyslipidemia, which inevitably leads to the premature manifestation of atherosclerosis, both coronary and peripheral. Up to 10,000 patients with this diagnosis are expected in the Czech Republic, but unfortunately their detection is dramatically lower.
FD must always be considered in patients with severe mixed DLP with a TC (total cholesterol)/TG (triglyceride) ratio of approximately 2(1) : 1. Patients suitable for further (especially genetic) examination can be reliably selected using the ratio of non- HDL-cholesterol/apolipoprotein B.
The definitive diagnosis is then determined by genotyping apolipoprotein E, rarely by ultracentrifugation of lipoproteins or electrophoretically. The basis of treatment are lifestyle measures; pharmacotherapy of choice is a combination of statin with fibrate.