脂蛋白 (a) 用不同的方程计算低密度脂蛋白胆固醇的度和达到目标值
Olga I Afanasieva1, Alexandra V Tyurina2, Elena A Klesareva1
1Institute of Experimental Cardiology, National Medical Research Center of Cardiology n.a. acad. E.I. Chazov, Ministry of Health of the Russian Federation, Moscow 121552, Russia.
Diseases (Basel, Switzerland)
|February 26, 2026
概括
升高的脂蛋白[Lp]可以膨胀低密度脂蛋白胆固醇 (LDL-C) 的测量. 对Lp(a) 胆固醇进行LDL-C的校正对于高Lp(a) 患者准确评估心血管风险至关重要.
科学领域:
- 心血管医学 心血管医学
- 临床化学 临床化学
- 脂质学 脂质学是指脂质学.
背景情况:
- 低密度脂蛋白胆固醇 (LDL-C) 是一个关键的心血管风险因素.
- 目前的LDL-C计算可能会高估患有升高脂蛋白 (Lp) 的患者的水平,这是所有含有apoB的脂蛋白的组成部分.
- 在高Lp存在的情况下,LDL-C测量的准确性仍然是争论的主题.
研究的目的:
- 调查不同脂蛋白[Lp[a]度对计算的低密度脂蛋白胆固醇 (LDL-C) 值的影响.
- 在Lp升高的情况下,评估不同的LDL-C计算方程的性能.
主要方法:
- 分析了来自283名患者的566个脂质和Lp (a) 测量值,包括脂质降低治疗前后的数据.
- 使用弗里德沃尔德,马丁-霍普金斯和桑普森方程计算Lp (a) - 胆固醇校正的LDL-C和LDL-C (LDL-Ccorr).
主要成果:
- 与弗里德沃尔德公式相比,马丁-霍普金斯和桑普森方程式将10%和13%的值重新分类到更高的风险类别.
- 脂蛋白 (a) - 胆固醇 (Lp) - C) 构成高达90%或更多的计算的LDL-C,取决于LDL-C和Lp) 度.
- 经过校正的LDL-C (LDL-Ccorr) 值,在根据临床LDL-C值进行分层时,导致30-59%的病例被重新分类到较低风险类别.
结论:
- 弗里德沃尔德,马丁-霍普金斯和桑普森方程显示,在没有高甘油三水平的患者中,LDL-C计算具有很高的一致性.
- 对于Lp (a) ≥30 mg/dL (马丁霍普金斯) 和≥41 mg/dL (桑普森) 的患者,建议使用LDL-Ccorr.
- 这些发现有助于临床医生准确地解释LDL-C目标的实现,并避免在患有升高Lp的患者中错误分类.
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