Investigation of the abnormal low-density lipoproteins occurring in patients with obstructive jaundice.

The abnormal lipoproteins of the density range 1.019-1.063g/cm3 occurring in the plasma of patients with obstructive jaundice were studied. Subfractionation of this density class by combined sodium phosphotungstate precipitation, ultracentrifugation, and column chromatography on hydroxyapatite and agarose gel yielded essentially three fractions: (1) lipoprotein-X, (2) A triglyceride-rich lipoprotein for which we propose the term lipoprotein-Y and (3) an abnormal lipoprotein, lipoprotein-B. Marked differences between these fractions with respect to electron-microscopic appearance, hydrated densities, chemical composition and immunochemical characteristics were observed. The protein moiety of lipoprotein-X consisted primarily of apolipoprotein-C and albumin. Lipoprotein-Y showed, in addition to apolipoprotein-C, the presence of apolipoprotein-B. The 'lipoprotein-B' fraction isolated from sera of these patients had higher triglyceride and free cholesterol contents than that of normal individuals and an unusually high content of apolipoprotein-C. The relative distribution of lipoprotein-X, lipoprotein-Y and 'lipoprotein-B' varied from patient to patient. The importance of considering the existence of lipoprotein-Y in screening patients for cholestasis by the lipoprotein-X test is discussed.