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Published on: November 10, 2017
Blood lipid measurements. Variations and practical utility.
G R Cooper1, G L Myers, S J Smith
1Division of Environmental Health Laboratory Sciences, Centers for Disease Control, Atlanta, GA 30333.
JAMA
|March 25, 1992
Summary
Biological and analytical variations significantly impact serum lipid levels and coronary heart disease risk. Understanding these variations helps estimate a patient's true cholesterol and guides testing frequency.
Area of Science:
- Clinical Chemistry
- Cardiovascular Disease Risk Assessment
- Biostatistics
Background:
- Serum lipid and lipoprotein levels are critical indicators for coronary heart disease (CHD) risk.
- Significant biological and analytical variations can affect the accuracy of these measurements.
- Interpreting lipid test results requires understanding the sources and magnitude of variation.
Purpose of the Study:
- To quantify the major biological and analytical sources of variation in serum lipid and lipoprotein levels.
- To assess the impact of these variations on CHD risk.
- To provide a method for estimating intraindividual variation and determining necessary specimen numbers for accurate cholesterol assessment.
Main Methods:
- Systematic review of over 300 publications on lipid variation sources.
- Selection of studies based on standardized conditions, clear results, and acceptable experimental design.
- Utilized quantitative measurements from standardized laboratories for representative lipid levels.
Main Results:
- Preanalytical variations (behavioral, clinical, sampling) account for approximately 60% of total variation in lipid measurements.
- A qualitative method is presented to estimate intraindividual biological variation using 2-3 serial specimens.
- Statistical analysis confirmed the reliability of data, though the estimation method provides qualitative results.
Conclusions:
- Preanalytical factors are the dominant source of variation in individual lipid measurements.
- Physicians can use the presented technique to estimate patient-specific variation and ensure adherence to National Cholesterol Education Program (NCEP) guidelines (intraindividual coefficient of variation <5.0%).
- A National Reference Method Network aims to address analytical challenges in lipid testing.
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