Type V hyperlipoproteinaemia is associated with hyperchylomicronaemia, high concentrations of VLDL and measurable levels of PHLA. The major metabolic impairment appears to be in the clearance of dietary fat. The most frequent clinical manifestations are recurrent abdominal pain, pancreatitis, hyperinsulinaemia and hyperuricaemia. The pattern presents in adulthood and is exacerbated by dietary fat, excessive caloric intake, excessive alcoholic intake and obesity. The mechanism of the disorder of the type V pattern is unknown but may involve the saturation of a catabolic process common to chylomicrons and VLDL. The type V pattern may be on a familial or inherited basis but more commonly it is secondary to another disease such as insulinopenic diabetes mellitus, pancreatitis, alcoholism, nephrosis or hypothyroidism. Subjects with familial type V may have first degree relatives with either a type IV or V pattern. The subject may be kept relatively free from abdominal pain by control of the hypertriglyceridaemia with diet and/or drug therapy.
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