Prognostic utility of biochemical markers of cardiovascular risk: impact of biological variability.
Prognostic utility of biochemical markers of cardiovascular risk: impact of biological variability.
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DOI：
10.1515/cclm-2012-0750
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发表时间：
2013-09
影响因子：
6.8
通讯作者：
Farrell DH
中科院分区：
文献类型：
--
作者：
Alexander KS;Kazmierczak SC;Snyder CK;Oberdorf JA;Farrell DH
虽然各种生化标志物用于帮助预测心血管疾病的风险，但用作风险评估工具的任何标志物的预后效用取决于该标志物在不同个体中显示的长期和短期生物学变异性。我们在一年的时间内从15名明显健康的个体中收集血液样本，测量总胆固醇、LDL和HDL胆固醇、甘油三酯、hsCRP、总纤维蛋白原和γ'纤维蛋白原。重复测量变异估计用于计算短期和长期组内相关系数（ICC），内和受试者之间的变异系数（分别为CVI和CVG），有效性系数和每个标记物的个体指数。HDL胆固醇表现出最低的变异性，ICC为0.84，CVI为11.1（95% CI：8.3，17.0）。hsCRP显示出最高水平的短期和长期受试者内变异性（CVI（95% CI）：分别为54.8（32.8，196.3）和77.1（53.3，141.3））。换句话说，它需要对多天收集的样本进行五次单独的hsCRP测量，以提供HDL胆固醇单次测量所提供的风险评估信息。γ'纤维蛋白原显示ICC为0.79，CVI为14.3（95% CI：10.6，21.9）。hsCRP显示出非常高生物学变异性，使得hsCRP的单次测量缺乏足够的临床效用来证明常规测量的合理性。γ'纤维蛋白原的变异性与HDL胆固醇没有显著差异，仅需要有限数量的测量来确定个体的心血管疾病风险。
While a variety of biochemical markers are used to help predict the risk of cardiovascular disease, the prognostic utility of any marker used as a risk assessment tool is dependent upon the long- and short-term biologic variability that the marker shows in different individuals. We measured total, LDL and HDL cholesterol, triglycerides, hsCRP, total fibrinogen and γ' fibrinogen in blood samples collected from 15 apparently healthy individuals over the course of one year. Repeated measures variation estimates were used to calculate short- and long-term intraclass correlation coefficients (ICC), within- and between-subject coefficients of variation (CVI and CVG, respectively), validity coefficients and indices of individuality for each marker. HDL cholesterol demonstrated the lowest variability profile, with an ICC of 0.84 and CVI of 11.1 (95% CI: 8.3, 17.0). hsCRP showed the highest levels of short- and long-term within-subject variability (CVI (95% CI): 54.8 (32.8, 196.3) and 77.1 (53.3, 141.3), respectively). Stated differently, it would require five separate measurements of hsCRP, performed on samples collected over multiple days, to provide the risk assessment information provided by a single measurement of HDL cholesterol. γ' fibrinogen demonstrated an ICC of 0.79 and CVI of 14.3 (95% CI: 10.6, 21.9). hsCRP showed very high biological variability, such that a single measurement of hsCRP lacks sufficient clinical utility to justify routine measurement. The variability profile of γ' fibrinogen was not markedly different than HDL cholesterol, necessitating only a limited number of measurements to establish an individual's risk of cardiovascular disease.
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影响因子：
6.7
作者：
Alexander, Kristine S.;Madden, Theresa E.;Farrell, David H.
通讯作者：
Farrell, David H.
影响因子：
1.1
作者：
Woodhams, B;Girardot, O;Gourmelin, Y
通讯作者：
Gourmelin, Y
影响因子：
37.8
作者：
Pearson, TA;Mensah, GA;Vinicor, F
通讯作者：
Vinicor, F
影响因子：
10.4
作者：
Manco-Johnson, M. J.;Dimichele, D.;Mannucci, P.
通讯作者：
Mannucci, P.
影响因子：
15.8
作者：
McCormack JP;Allan GM
通讯作者：
Allan GM