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需要考虑的因素与估计低密度脂蛋白胆固醇使用新的桑普森/NIH方程

Samantha Logan¹, Rajeevan Selvaratnam²

¹Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.

Clinical biochemistry

|August 17, 2023

概括

样本/国家卫生研究院 (NIH) 的LDL-C估计 (NeLDLc) 与非HDL-C的相关性比弗里德沃尔德估计 (FeLDLc) 更好. 然而,NeLDLc需要谨慎使用高甘油三或非常低的结果.

科学领域:

心血管医学心血管医学
临床化学临床化学
生物标记分析生物标记分析

背景情况:

弗里德沃尔德估计 (FeLDLc) 是低密度脂蛋白胆固醇 (LDLc) 的标准,但具有局限性.
样本/国家卫生研究院 (NIH) 对LDLc (NeLDLc) 的估计提供了更好的准确性.
非高密度脂蛋白胆固醇 (非HDLc) 是一种推的替代品,其切断值由2021年加拿大心血管学会 (CCS) 指南定义.

研究的目的:

为了评估NeLDLc与非HDLc相比在不同的甘油三水平上的准确性.
确定NeLDLc是否适合替代非HDLc,特别是在高甘油三血症的情况下.

主要方法:

在5年内对47,085名患者的120959个脂质样本进行了回顾性分析.
将NeLDLc和FeLDLc与非HDLc进行比较,分析一致性和回归作为甘油三水平的函数.

主要成果:

与FeLDLc相比,NeLDLc与非HDLc的相关性和一致性更高.
NeLDLc可以产生错误的负结果与增加的甘油三,甚至低于4.52 mmol/L.
在NeLDLc结果中观察到的最大变异在0.5mmol/L以下.

结论:

与FeLDLc相比,NeLDLc与非HDLc提供了更好的一致性.
当甘油三水平超过4.5mmol/L或结果低于0.5mmol/L时,建议对NeLDLc保持谨慎.
对于非HDLc的依赖,NeLDLc允许调整甘油三的切断界限 (1.7 mmol/L),与高甘油三血症标记保持一致.

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