评估目前用于测量LDL胆固醇的间接方法.
Sophia Drobnik1, Hubert Scharnagl2, Nilesh J Samani3
1Medical Clinic I, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Clinical chemistry and laboratory medicine
|February 18, 2025
概括
弗里德瓦尔德方程 (LDL-CFW) 为心血管风险评估提供可靠的低密度脂蛋白胆固醇 (LDL-C) 估计. 它不低于较新的方程,这证明了其在临床实践中持续的例行使用是合理的.
科学领域:
- 临床化学 临床化学
- 心血管疾病风险评估心血管疾病风险评估
- 脂质代谢 脂质代谢是什么
背景情况:
- 准确量化低密度脂蛋白胆固醇 (LDL-C) 对于心血管疾病 (CVD) 风险分层和治疗至关重要.
- 弗里德瓦尔德方程 (LDL-CFW) 被广泛使用,但因低估而受到批评,特别是高甘油三 (TG) 或低LDL-C.
- 替代方程,如马丁-霍普金斯 (LDL-CMH) 和桑普森 (LDL-CSN),已被提出以提高LDL-C的准确性.
研究的目的:
- 评估弗里德瓦尔德方程 (LDL-CFW) 与较新的LDL-C估计方法的准确性和一致性.
- 将LDL-CFW,LDL-CMH和LDL-CSN与参考β量化方法 (LDL-CUC) 进行比较.
- 为了确定LDL-CFW在心血管风险评估中常规使用的临床有效性.
主要方法:
- 分析了来自三项研究的5,738个数据集,比较了LDL-CFW,LDL-CMH和LDL-CSN与LDL-CUC.
- 评估LDL-C估计在一个范围的甘油三水平 (TG) 的评估,高达5.65 mmol/L.
- 统计比较包括中位数/平均差异,相关性和通过巴布洛克回归,以及一致性/不一致性分析.
主要成果:
- 所有经过测试的方程都提供了通常准确的LDL-C估计,但差异很小.
- 在TG<1.69 mmol/L时,两种方法之间没有发现显著的临床差异.
- 在更高的TG水平下,LDL-CFW显示出最准确的估计,超过LDL-CMH,并显示出与LDL-CSN的非劣势.
结论:
- 弗里德瓦尔德方程 (LDL-CFW) 为大多数临床情景提供可靠的LDL-C估计.
- 与LDL-CFW和LDL-CSN和LDL-CMH相比,LDL-CFW显示出非劣势,支持其继续使用.
- 鉴于目前的治疗指南依赖于LDL-CFW,其替代目前不合理.
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