Lipoprotein(a) repeat testing patterns and clinical significance of changes between repeat measurements: a real-world reference change value-based retrospective analysis.

IF 2.3 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry Pub Date : 2026-09-04 DOI:10.1016/j.clinbiochem.2026.111190

Beyazıt Semih Yeşil, Meltem Boz, Begüm Dokuzağaç, Şeyma Yeşil

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引用次数: 0

Abstract

Introduction: We evaluated lipoprotein(a) [Lp(a)] repeat testing patterns, inter-measurement intervals, department-specific repeat testing rates, and the clinical significance of changes between repeat measurements using asymmetric reference change values (RCV) and risk-category reclassification.

Materials and methods: All Lp(a) results from 1 April 2024 to 1 April 2026 at a tertiary hospital laboratory in Istanbul, Türkiye, were retrospectively extracted. Results were classified as low (<0.3 g/L), intermediate (0.3-0.5 g/L), or high (>0.5 g/L). The asymmetric RCV, calculated using an individual biological variation coefficient of 10.2% (EFLM Biological Variation Database) and analytical variation coefficient of 3.6% (internal quality control), were + 34.9% and - 25.9%. Pearson chi-square tests and Wilson 95% confidence intervals were applied.

Results: Among 1623 patients with 1730 results, 96 (5.9%) underwent repeat testing, generating 107 consecutive pairs. Median inter-measurement interval was 156 days (IQR 71-234). Repeat testing rates did not differ by initial category (low 5.7%, intermediate 8.1%, high 5.3%; χ² = 1.693, p = 0.429). RCV exceedance occurred in 23.4% (95% CI 16.4-32.2%), clinical reclassification in 11.2% (95% CI 6.5-18.6%), and both in 5.6% (95% CI 2.6-11.7%). RCV exceedance by baseline category was 20.8%, 33.3%, and 25.0% in low, intermediate, and high pairs, respectively. RCV exceedance did not differ between <90-day and ≥ 90-day intervals (17.6% vs. 26.0%, p = 0.340).

Conclusions: Most repeat measurements remained within the RCV, and clinical reclassification was uncommon. Initial Lp(a) category did not predict repeat testing behaviour, suggesting requesting decisions reflect clinical context rather than the biochemical result. These findings support selective, indication-driven repeat testing rather than routine serial monitoring.

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脂蛋白(a)重复测试模式和重复测量之间变化的临床意义：一项基于真实世界参考变化值的回顾性分析。

我们使用不对称参考变化值（RCV）和风险分类重分类评估脂蛋白(a) [Lp(a)]重复检测模式、测量间隔、科室特定重复检测率以及重复测量之间变化的临床意义。材料和方法：回顾性提取基耶市伊斯坦布尔一家三级医院实验室2024年4月1日至2026年4月1日的所有Lp(a)结果。结果归类为低（0.5 g/L）。采用个体生物变异系数10.2% （EFLM生物变异数据库）和分析变异系数3.6%（内部质量控制）计算的非对称RCV分别为 + 34.9%和 - 25.9%。采用Pearson卡方检验和Wilson 95%置信区间。结果：1623例患者中有1730例结果，96例（5.9%）重复检测，产生107对连续检测结果。测量间间隔中位数为156 天（IQR 71-234）。重复检测率在初始分类中无差异（低5.7%，中8.1%，高5.3%;χ2 = 1.693,p = 0.429）。RCV超标发生率为23.4% (95% CI 16.4-32.2%)，临床重分类发生率为11.2% (95% CI 6.5-18.6%)，两者发生率均为5.6% （95% CI 2.6-11.7%）。在低、中、高对中，基线类别的RCV超标率分别为20.8%、33.3%和25.0%。结论：大多数重复测量保持在RCV范围内，临床重新分类并不常见。最初的Lp(a)类别不能预测重复测试行为，这表明请求决定反映临床情况而不是生化结果。这些发现支持选择性的、指征驱动的重复检测，而不是常规的连续监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.