Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Plasma lysophosphatidylcholine (LPC) concentration is diminished in patients with lecithin cholesterol acyltransferase (LCAT) deficiency. LCAT is the enzyme responsible for synthesizing the majority of cholesteryl esters in serum by transferring fatty acid from phosphatidylcholine to the 3-hydroxyl group of cholesterol. It is believed that LCAT regulates the transport of cholesterol between extravascular and intravascular pools. In the theoretical pathway known as reverse cholesterol transport, cholesterol is moved from peripheral tissues to the liver for catabolism. The esterification of cholesterol by LCAT in serum serves to maintain a chemical concentration gradient for unesterified cholesterol between peripheral tissue cells and the serum.
LPC additionally has been shown to play a functional role in various biological processes including cell migration, cell proliferation, angiogenesis, and inflammation. LPC stimulates monocyte chemoattractant protein-1 and induces expression of adhesion molecules on the surface of endothelial cells and, thus, may play a role in coronary atherogenesis.
Detecting lecithin cholesterol acyltransferase deficiency
Decreased values for 16:0 lysophosphatidylcholine (LPC) and 18:0 LPC are consistent with lecithin cholesterol acyltransferase deficiency.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
> or =16 years: > or =62 mcmol/L
> or =16 years: > or =20 mcmol/L
Reference values have not been established for patients that are <16 years of age.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Santamarina-Fojo S, Hoeg JM, Assman G, Brewer HB Jr: Lecithin cholesterol acyltransferase deficiency and fish eye disease. In The Metabolic and Molecular Basis of Inherited Disease. 8th edition. Edited by C Scriver, A Beaudet, W Sly, et al. New York, McGraw-Hill Book Company, 2001, pp 2817-2833
2. Tselepis AD, Chapman JM: Inflammation, bioactive lipids and atherosclerosis: potential roles of a lipoprotein-associated phospholipase A2, platelet-activating factor-acetylhydrolase. Atheroscler Suppl 2002 Dec;3(4):57-68