More accurate LDL-C calculation: Externally validated, guideline endorsed
More accurate LDL-C calculation: Externally validated, guideline endorsed
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DOI：
10.1016/j.cca.2020.03.030
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发表时间：
2020-07-01
影响因子：
5
通讯作者：
Martin, Seth S.
中科院分区：
文献类型：
--
作者：
Brownstein, Adam J.;Martin, Seth S.
低密度脂蛋白胆固醇（LDL-C）是预防动脉粥样硬化性心血管疾病（ASCVD）的主要治疗靶点。最近发布的欧洲和美国脂质管理指南建议在高风险和极高风险患者中达到非常低的LDL-C水平（< 1.8 mmol/L或甚至更低）。因此，利用准确的方法测定LDL-C，尤其是在如此低的值下，对于告知最佳临床决策和有效疗法的使用至关重要。本综述比较了不同的方法确定LDL-C，包括各种形式的直接测量和最常用的计算。本综述讨论了这些方法在不同患者人群中以及空腹与非空腹状态下的证据。Martin/霍普金斯法是测定LDL-C的首选方法，因为它是最准确和最广泛适用的方法。它特别适用于低LDL-C水平< 1.8 mmol/L（< 70 mg/dL）和高甘油三酯水平介于1.7和4.5 mmol/L（150-399 mg/dL）之间的患者，并且在非空腹状态下是可靠的。
Low density lipoprotein-cholesterol (LDL-C) serves as the primary target of therapy for preventing atherosclerotic cardiovascular disease (ASCVD). Recently released European and American guidelines on lipid management recommend attaining very low LDL-C levels ( < 1.8 mmol/L or even lower) in high and very-high risk patients. Therefore, utilizing an accurate means for determining LDL-C, especially at such low values, is of paramount importance to inform the best clinical decisions and use of effective therapies. This review compares the different methods of determining LDL-C, including the various forms of direct measurement and most commonly used calculations. This review discusses the evidence behind these methods in different populations of patients and in the fasting versus non-fasting state. The Martin/Hopkins method is the preferred method for determining LDL-C as it is the most accurate and widely applicable method. It is especially useful in patients with low LDL-C levels < 1.8 mmol/L ( < 70 mg/dL) and high triglyceride levels between 1.7 and 4.5 mmol/L (150-399 mg/dL), and is reliable in the non-fasting state.