验证NIH LDL-C方程在艾伯塔省的省级实施。

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY Clinical biochemistry Pub Date : 2023-10-21 DOI:10.1016/j.clinbiochem.2023.110678

V. Higgins , L. Garcia , J.L. Gifford , N. Volodko , D.R. Beriault , M.L. Parker , M.P. Estey , D.T. Proctor , O.Z. Ismail

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引用次数: 0

摘要

背景：LDL-C是一种心血管疾病风险评估生物标志物，通常使用弗里德瓦尔德方程计算。NIH方程克服了Friedewald方程的几个局限性。根据加拿大临床化学家协会（CSCC）的脂质报告建议，我们在艾伯塔省实施NIH LDL-C方程之前对其进行了评估。方法：从阿尔伯塔省使用的五个分析仪器组中获得一年（2021年1月1日至2021年12月31日）的脂质结果（数据清理后n=1486584）。根据年龄、分析仪器组和禁食状态对所有数据进行分析。测定Friedewald和NIH计算的LDL-C之间的相关性，以及Friedewald与NIH计算LDL-C差异与每个脂质参数之间的相关性。比较了两个方程之间LDL-C结果不可重复/不准确的频率。在LDL-C阈值下确定两个方程和非HDL-C之间的一致性。最后，将Friedewald、NIH和Martin Hopkins方程计算的LDL-C与密度梯度超速离心进行比较。结果：当甘油三酯≤4.52mmol/L时，Friedewald和NIH计算的LDL-C表现出最强的相关性。Friedewald与NIH计算LDL-C之间的差异随着LDL-C浓度的降低而增加。NIH方程产生的不准确结果较少（0.35%对22.0%）。在所有LDL-C阈值下，方程之间的一致性百分比>96%，这表明大多数患者不需要改变治疗。当甘油三酯≤9.04mmol/L时，NIH计算的LDL-C与非HDL-C表现出更好的一致性，并且与通过超速离心测量的LDL-C更好地相关（r2=0.926对0.775（Friedewald）和0.863（Martin Hopkins））。不同年龄、分析仪器组和禁食状态的结果一致。结论：我们的研究结果证明了在阿尔伯塔省实施NIH方程的好处。

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Validating the NIH LDL-C equation for provincial implementation in Alberta

Background

LDL-C, a cardiovascular disease risk assessment biomarker, is commonly calculated using the Friedewald equation. The NIH equation overcomes several limitations of the Friedewald equation. Consistent with the Canadian Society of Clinical Chemists (CSCC) lipid reporting recommendations, we assessed the NIH LDL-C equation in Alberta prior to its provincial implementation.

Methods

1-year (01/01/2021–12/31/2021) of lipid results (n = 1,486,584 after data cleaning) were obtained from five analytical instrument groups used across Alberta. Analyses were performed on all data and after separating by age, analytical instrument group, and fasting status. The correlation between Friedewald- and NIH-calculated LDL-C and between Friedewald- and NIH-calculated LDL-C difference and each lipid parameter, was determined. The frequency of unreportable/inaccurate LDL-C results was compared between the two equations. The concordance between the two equations and with non-HDL-C was determined at LDL-C thresholds. Lastly, LDL-C calculated by Friedewald, NIH, and Martin-Hopkins equations was compared to density-gradient ultracentrifugation.

Results

Friedewald- and NIH-calculated LDL-C exhibit the strongest correlation when triglycerides ≤ 4.52 mmol/L. The difference between Friedewald- and NIH-calculated LDL-C increases with decreasing LDL-C concentration. The NIH equation yields fewer inaccurate results (0.35 % vs. 22.0 %). The percent agreement between equations was > 96 % at all LDL-C thresholds, suggesting most patients will not require treatment changes. NIH-calculated LDL-C exhibited better agreement with non-HDL-C when triglycerides ≤ 9.04 mmol/L and better correlated with LDL-C measured by ultracentrifugation (r² = 0.926 vs. 0.775 (Friedewald) and 0.863 (Martin-Hopkins)). Results were consistent across age, analytical instrument group, and fasting status.

Conclusions

Our findings demonstrate the benefits of implementing the NIH equation across Alberta.

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来源期刊

Clinical biochemistry 医学-医学实验技术

CiteScore

5.10

自引率

0.00%

发文量

151

审稿时长

25 days

期刊介绍： Clinical Biochemistry publishes articles relating to clinical chemistry, molecular biology and genetics, therapeutic drug monitoring and toxicology, laboratory immunology and laboratory medicine in general, with the focus on analytical and clinical investigation of laboratory tests in humans used for diagnosis, prognosis, treatment and therapy, and monitoring of disease.