Non-HDL Cholesterol Shows Improved Accuracy for Cardiovascular Risk Score Classification Compared to Direct or Calculated LDL Cholesterol in a Dyslipidemic Population
Non-HDL Cholesterol Shows Improved Accuracy for Cardiovascular Risk Score Classification Compared to Direct or Calculated LDL Cholesterol in a Dyslipidemic Population
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DOI：
10.1373/clinchem.2010.154773
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发表时间：
2011-03-01
影响因子：
9.3
通讯作者：
Remaley, Alan T.
中科院分区：
文献类型：
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作者：
van Deventer, Hendrick E.;Miller, W. Greg;Remaley, Alan T.
背景：我们的目的是评估通过直接低密度脂蛋白胆固醇（dLDL - C）、计算的低密度脂蛋白胆固醇（cLDL - C）和非高密度脂蛋白胆固醇（non - HDL - C）对心血管疾病（CVD）风险评分分类的准确性，并与美国疾病控制与预防中心（CDC）采用的参考测量程序（RMPs）分类进行比较。
方法：我们检查了175人，其中包括138名患有心血管疾病或可能影响低密度脂蛋白胆固醇测量的疾病患者。使用Denka、Kyowa、Sekisui、Serotec、Sysmex、UMA和Wako试剂进行dLDL - C测量。cLDL - C通过Friedewald方程计算，使用各制造商的直接高密度脂蛋白胆固醇测定值，总胆固醇和甘油三酯分别采用Roche和Siemens（Advia）测定法测量。
结果：对于甘油三酯<2.26 mmol/L（<200 mg/dL）的参与者，与RMP相比，cLDL - C方法对心血管疾病风险评分的总体错误分类率为5% - 17%，dLDL - C方法为8% - 26%。只有Wako的dLDL - C比其相应的cLDL - C方法错误分类更少（8%对17%；P < 0.05）。8种方法中有4种非高密度脂蛋白胆固醇测定法比dLDL - C错误分类的患者更少（P < 0.05）。对于甘油三酯≥2.26 mmol/L（≥200 mg/dL）且<4.52 mmol/L（<400 mg/dL）的参与者，一般来说，dLDL - C方法比cLDL - C方法表现更好，并且非高密度脂蛋白胆固醇方法在心血管疾病风险评分方面与RMP的一致性比dLDL - C或cLDL - C方法更好。
结论：除了高甘油三酯血症个体外，8种dLDL - C方法中有7种在心血管疾病风险评分分类上未显示出比相应的cLDL - C方法有所改善。对于正常和高甘油三酯血症个体的心血管疾病风险评分分类，非高密度脂蛋白胆固醇总体上与RMP的一致性最佳。（C）2010美国临床化学协会
BACKGROUND: Our objective was to evaluate the accuracy of cardiovascular disease (CVD) risk score classification by direct LDL cholesterol (dLDL-C), calculated LDL cholesterol (cLDL-C), and non-HDL cholesterol (non-HDL-C) compared to classification by reference measurement procedures (RMPs) performed at the CDC.METHODS: We examined 175 individuals, including 138 with CVD or conditions that may affect LDL-C measurement. dLDL-C measurements were performed using Denka, Kyowa, Sekisui, Serotec, Sysmex, UMA, and Wako reagents. cLDL-C was calculated by the Friedewald equation, using each manufacturer's direct HDL-C assay measurements, and total cholesterol and triglyceride measurements by Roche and Siemens (Advia) assays, respectively.RESULTS: For participants with triglycerides < 2.26 mmol/L (< 200 mg/dL), the overall misclassification rate for the CVD risk score ranged from 5% to 17% for cLDL-C methods and 8% to 26% for dLDL-C methods when compared to the RMP. Only Wako dLDL-C had fewer misclassifications than its corresponding cLDL-C method (8% vs 17%; P < 0.05). Non-HDL-C assays misclassified fewer patients than dLDL-C for 4 of 8 methods (P < 0.05). For participants with triglycerides >= 2.26 mmol/L (>= 200 mg/dL) and < 4.52 mmol/L (< 400 mg/dL), dLDL-C methods, in general, performed better than cLDL-C methods, and non-HDL-C methods showed better correspondence to the RMP for CVD risk score than either dLDL-C or cLDL-C methods.CONCLUSIONS: Except for hypertriglyceridemic individuals, 7 of 8 dLDL-C methods failed to show improved CVD risk score classification over the corresponding cLDL-C methods. Non-HDL-C showed overall the best concordance with the RMP for CVD risk score classification of both normal and hypertriglyceridemic individuals. (C) 2010 American Association for Clinical Chemistry