Identification of novel biomarkers to distinguish polygenic and monogenic dyslipidemia system biology approach

Dyslipidaemia is one of the major cardiovascular risk factors, it can be due to primary causes (i.e. monogenic, characterized by a single gene mutation, or dyslipidaemia of polygenic/environmental causes), or secondary to specific disorders such as obesity, diabetes mellitus or hypothyroidism. Monogenic patients present the most severe phenotype and so they need to be identified in early age so pharmacologic treatment can be implemented to decrease the cardiovascular risk. However the majority of hyperlipidemic patients most likely have a polygenic disease that can be mainly controlled just by the implementation of a healthy lifestyle. Thus, the distinction between monogenic and polygenic dyslipidaemia is important for a prompt diagnosis, cardiovascular risk assessment, counselling and treatment. Besides the already stated biomarkers as LDL, apoB and apoB/apoA-I ratio, other promising (yet, needing further research) biomarkers for clinical differentiation between dyslipidaemias are apoE, sdLDL, apoC-2 and apoC-3. However, none of these biomarkers can explain the complex lipid profile of the majority of these patients.