Does correction of the friedewald formula using lipoprotein(a) change our estimation of ischemic heart disease risk?: The Quebec Cardiovascular Study
Does correction of the friedewald formula using lipoprotein(a) change our estimation of ischemic heart disease risk?: The Quebec Cardiovascular Study
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DOI：
10.1016/s0021-9150(02)00034-5
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发表时间：
2002-08-01
期刊：
影响因子：
5.3
通讯作者：
Dagenais, GR
中科院分区：
文献类型：
--
作者：
Cantin, B;Lamarche, B;Dagenais, GR
背景：低密度脂蛋白胆固醇通常使用弗里德瓦尔德公式计算。这种计算方法没有考虑与低密度脂蛋白胆固醇相关的脂蛋白(a)的存在。Dahlen建议应该修改弗里德瓦尔德公式，以考虑Lp(a)相关的胆固醇。本研究旨在确定Friedewald公式的修正是否能更好地评估缺血性心脏病（IHD）的风险。方法：对2222例无IHD的男性进行5年的前瞻性随访，观察心肌梗死、冠状动脉功能不全或冠状动脉死亡的发生情况。在基线评估时，所有人都有一个完整的空腹脂质谱，包括Lp(a)测定。使用弗里德瓦尔德公式和Dahlen对弗里德瓦尔德公式的修改，从总胆固醇、总甘油三酯和高密度脂蛋白胆固醇中计算出ldl -胆固醇水平。结果：随访期间有89例首次IHD事件。两种类型的ldl -胆固醇计算都表明，使用Dahlen修正的Friedewald公式（RR: 2.18； 95%置信限：1.25-3.81），与第一个分位数相比，最后一个低密度脂蛋白胆固醇分布的可生育性是相对风险的两倍（RR: 2.15； 95%置信限：1.23-3.75）。Lp(a)水平不是IHD风险的独立预测因子。结论：修改Friedewald公式以考虑Lp(a)水平并不能改善我们对IHD风险的评估。(C) 2002爱思唯尔科学爱尔兰有限公司版权所有。
Background: LDL-cholesterol is usually calculated using the Friedewald formula. This calculation method does not take into account the presence of Lp(a), which is associated with LDL-cholesterol. Dahlen has suggested that the Friedewald formula should be modified to account for Lp(a) associated cholesterol. This study was undertaken to determine if correction of the Friedewald formula would result in a better evaluation of ischemic heart disease (IHD) risk. Methods: 2222 men free from IHD were prospectively followed for 5 years for the appearance of myocardial infarction, coronary insufficiency or coronary death. At the baseline evaluation all had a complete fasting lipid profile which included Lp(a) determinations. LDL-cholesterol levels were calculated from total cholesterol, total triglycerides and HDL-cholesterol using the Friedewald formula and also using the Dahlen modification of the Friedewald formula. Results: During the follow-up there were 89 first IHD events. Both types of LDL-cholesterol calculations showed that the last fertile of the LDL-cholesterol distribution in comparison to the first tertile, doubles the relative risk (RR: 2.15; 95% confidence limits: 1.23-3.75) using the Friedewald formula (RR: 2.18; 95% confidence limits: 1.25-3.81) using the Dahlen modification. Lp(a) levels were not an independent predictor of IHD risk. Conclusion: Modification of the Friedewald formula to account for Lp(a) levels does not improve our evaluation of IHD risk. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.