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Fredrickson classification of lipid disorders and associated xanthomas[1,2]

Fredrickson classification of lipid disorders and associated xanthomas[1,2]
Frederickson phenotype Lipoprotein abnormality Typical lipid levels Xanthomas Observed
I Chylomicrons TG >99th percentile Eruptive
IIa LDL TC >90th percentile; depending upon type, may also see TG and/or apolipoprotein B ≥90th percentile Tendinous, tuberous, interdigital xanthomas
IIb LDL and VLDL Depending upon type, TC and/or TG ≥90th percentile and apolipoprotein B ≥90th percentile Tuberous
III Remnants of VLDL and chylomicrons TC and TG >90th percentile Tuberoeruptive xanthomas (80% of patients); plane xanthomas of the palmar creases (xanthoma striatum palmare [2/3 of patients])
IV VLDL TC >90th percentile; depending upon type, may also see TG >90th percentile or low HDL Eruptive
V Chylomicrons and VLDL TG >99th percentile Eruptive
TG: triglycerides; LDL: low-density lipoprotein; TC: total cholesterol; VLDL: very-low-density lipoprotein.
References:
  1. Fredrickson DS, Levy RI, Lees RS. Fat transport in lipoproteins--an integrated approach to mechanisms and disorders. N Engl J Med 1967; 276:148.
  2. Fredrickson DS. An international classification of hyperlipidemias and hyperlipoproteinemias. Ann Intern Med 1971; 75:471.
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