Discrepant Risk Assessment between Low-Density Lipoprotein Cholesterol and Low-Density Lipoprotein Size.

IF 1.8 Q3 MEDICAL LABORATORY TECHNOLOGY
Nicholas E Larkey, Leslie J Donato, Allan S Jaffe, Vlad C Vasile, Jeffrey W Meeusen
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引用次数: 0

Abstract

Background: Low-density lipoprotein cholesterol (LDL-C) is directly associated with coronary artery disease (CAD) risk. Subfractionation of LDL enables differentiation between large-buoyant LDL (>20.5 nm) and small-dense LDL (≤20.5 nm). Small-dense LDL reportedly increases CAD risk, as do LDL-C and LDL particle (LDL-P) concentrations. Nuclear magnetic resonance spectroscopy (NMR) reports LDL-C, LDL-P, and LDL size (LDL-s). We investigated associations between these outputs and their agreement on CAD risk information.

Methods: Associations between LDL-P, LDL-C, and LDL-s measured by NMR were evaluated in serum from clinically ordered samples (n = 26 710), and a subset of patients with CAD evaluation from coronary angiography (n = 356). Correlations were determined using Spearman ρ, and clinical classifications were compared using the following thresholds for increased risk: LDL-C > 160 mg/dL, LDL-P > 1600 nmol/L, and LDL-S < 20.5 nm.

Results: The large laboratory NMR data set showed LDL-C was highly correlated with LDL-P (ρ = 0.87), and moderately with LDL-s (ρ = 0.51). Correlation between LDL-P and LDL-s was weakest (ρ = 0.21). When comparing pairwise high- and low-risk laboratory values, concordant values were observed in 99.8%, 43%, and 25% of cases for LDL-P/LDL-C, LDL-s/LDL-P, and LDL-C/LDL-s, respectively. In patients with angiography and NMR results, CAD was diagnosed in 40% (6/15) of patients with concordant high-risk LDL-C and small-dense LDL-s in the smaller patient cohort, but only 19% (6/31) of CAD-positive patients with high-risk LDL-C had small-dense LDL-s.

Conclusions: LDL-s and LDL-C are frequently discordant at established LDL-C risk cutoffs. CAD diagnosis was found in similar numbers regardless of LDL-s phenotype.

低密度脂蛋白胆固醇与低密度脂蛋白大小差异风险评估。
背景:低密度脂蛋白胆固醇(LDL-C)与冠状动脉疾病(CAD)风险直接相关。低密度脂蛋白的细分可以区分大浮力LDL (>20.5 nm)和小密度LDL(≤20.5 nm)。据报道,小密度LDL会增加冠心病风险,LDL- c和LDL颗粒(LDL- p)浓度也是如此。核磁共振波谱(NMR)报告LDL- c、LDL- p和LDL-s大小。我们调查了这些输出和他们对CAD风险信息的一致意见之间的联系。方法:评估临床订购样本(n = 26710)的血清中LDL-P、LDL-C和LDL-s之间的相关性,以及冠状动脉造影评估的CAD患者亚组(n = 356)。使用Spearman ρ确定相关性,并使用以下风险增加阈值比较临床分类:LDL-C > 160 mg/dL, LDL-P > 1600 nmol/L, LDL-S < 20.5 nm。结果:大型实验室核磁共振数据集显示LDL-C与LDL-P高度相关(ρ = 0.87),与LDL-s中度相关(ρ = 0.51)。LDL-P与LDL-s相关性最弱(ρ = 0.21)。当两两比较高风险和低风险实验室值时,分别在99.8%、43%和25%的病例中观察到LDL-P/LDL-C、LDL-s/LDL-P和LDL-C/LDL-s的一致性值。在有血管造影和核磁共振结果的患者中,在较小的患者队列中,40%(6/15)高危LDL-C和小密度LDL-C一致的患者被诊断为CAD,而只有19%(6/31)的高危LDL-C阳性患者被诊断为小密度LDL-C。结论:ldl - 5和LDL-C在确定的LDL-C风险临界值上经常不一致。无论LDL-s表型如何,CAD诊断的人数相似。
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来源期刊
Journal of Applied Laboratory Medicine
Journal of Applied Laboratory Medicine MEDICAL LABORATORY TECHNOLOGY-
CiteScore
3.70
自引率
5.00%
发文量
137
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