{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:24:59Z","timestamp":1787214299886,"version":"build-2736575974"},"reference-count":11,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Lipoprotein X is an abnormal lipoprotein formed in cholestatic liver disease that causes artifactual elevation of calculated and measured direct low-density lipoprotein cholesterol (LDL-C). A 40-year-old man with chronic pancreatitis presented with hyperglycemic hyperosmolar state secondary to type 3c diabetes. He was jaundiced, with total bilirubin of 9.4\u2005mg\/dL (SI: 161\u2005\u00b5mol\/L) (reference range, 0.3-1.4\u2005mg\/dL [SI: 5-24\u2005\u00b5mol\/L]). Abdominal computed tomography showed severe common bile duct stricturing causing obstructive cholestasis. Laboratory results revealed a physiologically implausible lipid profile: total cholesterol (TC) of 1531\u2005mg\/dL (SI: 39.6\u2005mmol\/L) (desirable concentration, &amp;lt;200\u2005mg\/dL [SI: &amp;lt;5.2\u2005mmol\/L]) and direct LDL-C of 1636\u2005mg\/dL (SI: 42.3\u2005mmol\/L) (desirable concentration, &amp;lt;100\u2005mg\/dL [SI: &amp;lt;2.6\u2005mmol\/L]). Low-density lipoprotein cholesterol exceeding TC indicated analytical interference. Apolipoprotein B (ApoB) was elevated: 278\u2005mg\/dL (SI: 2.78\u2005g\/L) (reference range, 66-144\u2005mg\/dL [SI: 0.66-1.44\u2005g\/L]). The TC:ApoB ratio was 6.9\u2005mmol\/g (reference range, 3.8-6.3\u2005mmol\/g), supporting coexistent ApoB-negative lipoprotein. Liver and lipid parameters improved post-biliary stenting. ApoB normalized at 6 weeks, supporting a transient, insulin-deficiency-related ApoB-containing lipoprotein excess. Clinicians should suspect lipoprotein X when LDL-C exceeds TC in the setting of cholestasis; if ApoB is also elevated, transient ApoB-mediated dyslipidemia may coexist. Management centers on correcting underlying biliary and metabolic pathology.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag230","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T11:48:10Z","timestamp":1785930490000},"source":"Crossref","is-referenced-by-count":0,"title":["Lipoprotein X: artifactual lipid derangement in type 3c diabetes with obstructive liver disease"],"prefix":"10.1210","volume":"4","author":[{"given":"Deirdre","family":"Green","sequence":"first","affiliation":[{"name":"Dept. of Endocrinology, Mater Misericordiae University Hospital , Dublin 7, D07 R2WY ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3813-3234","authenticated-orcid":false,"given":"Anusha","family":"Prem Kumar","sequence":"additional","affiliation":[{"name":"Dept. of Endocrinology, Mater Misericordiae University Hospital , Dublin 7, D07 R2WY ,","place":["Ireland"]},{"name":"UCD School of Medicine, University College Dublin , Dublin 4, D04 V1W8 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Byrne","sequence":"additional","affiliation":[{"name":"Dept. of Clinical Chemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital , Dublin 7, D07 R2WY ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Byrne","sequence":"additional","affiliation":[{"name":"Dept. of Clinical Chemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital , Dublin 7, D07 R2WY ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham R","family":"Lee","sequence":"additional","affiliation":[{"name":"UCD School of Medicine, University College Dublin , Dublin 4, D04 V1W8 ,","place":["Ireland"]},{"name":"Dept. of Clinical Chemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital , Dublin 7, D07 R2WY 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