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WHO/Fredrickson classification of primary hyperlipidaemias

Last reviewed Jul 20, 2021

Frederickson Classification of Lipid Disorders

Type	Average of overnight serum	Elevated particles	Associated clinical disorders	Serum TC	Serum TG
I	Creamy top layer	Chylomicrons	Lipoprotein lipase deficiency, apolipoprotein C-II deficiency	N	++
IIa	Clear	LDL	Familial hypercholesterolemia, polygenic hypercholesterolemia, nephrosis, hypothyroidism, familial combined hyperlipidemia	++	N
IIb	Clear	LDL, VLDL	Familial combined hyperlipidemia	++	+
III	Turbid	IDL	Dysbetalipoproteinemia	+	+
IV	Turbid	VLDL	Familial hypertriglyceridemia, familial combined hyperlipidemia, sporadic hypertriglyceridemia, diabetes	N+	++
V	Creamy top, turbid bottom	Chylomicrons, VLDL	Diabetes	+	++

Note that the WHO classification is simply a biochemical phenotypic classification based on which lipoprotein is raised. Also the classification was devised before the importance of HDL as a prognostic indicator was recognised.

* IDL = intermediate-density lipoproteins; LDL = low-density lipoproteins; TC = total cholesterol; TG = triglycerides; VLDL = very low-density lipoproteins;

+ = increased; ++ = greatly increased; N= normal; N+ = normal or increased

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WHO/Fredrickson classification of primary hyperlipidaemias

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