一个改进的Sampson-NIH方程与提高准确性估计低水平低密度脂蛋白-胆固醇。

IF 6.3 2区医学 Q1 MEDICAL LABORATORY TECHNOLOGY

Clinical chemistry Pub Date : 2025-07-09 DOI:10.1093/clinchem/hvaf073

Maureen Sampson,Rafael Zubiran,Anna Wolska,Jeffrey W Meeusen,Leslie J Donato,Allan S Jaffe,Giorgio E M Melloni,Robert P Giugliano,Marc S Sabatine,Nicholas A Marston,Alan T Remaley

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引用次数: 0

摘要

长期以来，心血管指南推荐低密度脂蛋白-胆固醇（LDL-C）作为降脂治疗的主要靶点。最近的指南强调了实现低LDL-C水平的重要性；因此，低LDL-C的准确测量越来越具有临床意义。方法利用梅奥诊所（n = 24 590）和evolocumab的FOURIER临床试验（n = 9605）的脂质面板检测结果，通过最小二乘回归建立以下修正Sampson方程，通过β-定量参比法匹配LDL-C (mg/dL)，将各项合并为非高密度脂蛋白胆固醇（nonHDLC =总胆固醇-高密度脂蛋白胆固醇）并强制系数为1。结果与其他方程相比，改进的Sampson方程与参考方法的一致性有显著提高（Lin一致性相关系数为0.992,P < 0.001）。总体kappa分析表明，55 mg/dL的临界值（1.4 mmol/L, 0.98 [P < 0.001], Sampson-NIH: 0.96, Martin-Hopkins: 0.96, Friedewald: 0.94）和70 mg/dL的临界值（1.8 mmol/L, 0.97 [P < 0.001], Sampson-NIH: 0.94, Martin-Hopkins: 0.95, Friedewald: 0.92）与参考方法最吻合。修正Sampson方程在55 mg/dL （15%, [P < 0.001]）、Sampson- nih: 29%、Martin-Hopkins: 28%、Friedewald: 37%和70 mg/dL （18%, [P < 0.001]）时的错误分类率也显著低于其他方程；Sampson-NIH: 30%, Martin-Hopkins: 28%。%，弗里德瓦尔德：34%)。与基于净重分类指数的其他公式相比，新公式将低LDL-C正确分类患者的百分比提高了约10%至20%。结论与其他低LDL-C方程相比，改进的Sampson方程具有更高的准确性。它能更准确地识别出未达到LDL-C目标的高危患者，并能从更强化的降脂治疗中获益。

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A Modified Sampson-NIH Equation with Improved Accuracy for Estimating Low Levels of Low-Density Lipoprotein-Cholesterol.

BACKGROUND Cardiovascular guidelines have long recommended low-density lipoprotein-cholesterol (LDL-C) as the primary target for lipid-lowering therapy. Recent guidelines have emphasized the importance of achieving low LDL-C levels; hence, the accurate measurement of low LDL-C is increasingly clinically relevant. METHODS Using lipid panel test results from the Mayo Clinic (n = 24 590) and the FOURIER clinical trial of evolocumab (n = 9605), the following modified Sampson equation was developed by least-squares regression to match LDL-C (mg/dL) by the β-quantification reference method, by combining terms into non High Density Lipoprotein Cholesterol (nonHDLC = Total Cholesterol - High Density Lipoprotein Cholesterol) and forcing the coefficient to be one. RESULTS The modified Sampson equation demonstrated significant improvement in its concordance to the reference method compared to other equations (the Lin Concordance Correlation Coefficient 0.992, P < 0.001). By overall kappa analysis, it showed the best agreement to the reference method at the 55 mg/dL cutpoint (1.4 mmol/L, 0.98 [P < 0.001], Sampson-NIH: 0.96, Martin-Hopkins: 0.96, Friedewald: 0.94) and the 70 mg/dL cutpoint (1.8 mmol/L, 0.97 [P < 0.001], Sampson-NIH: 0.94, Martin-Hopkins: 0.95, Friedewald: 0.92). The false classification rate of the modified Sampson equation was also significantly lower compared to the other equations at 55 mg/dL (15%, [P < 0.001], Sampson-NIH: 29%, Martin-Hopkins: 28%, Friedewald: 37%) and 70 mg/dL (18%, [P < 0.001]; Sampson-NIH: 30%, Martin-Hopkins: 28.%, Friedewald: 34%). The new equation increases the percentage of correctly classified patients with low LDL-C by approximately 10% to 20% over the other equations based on its net reclassification index. CONCLUSIONS The modified Sampson equation shows improved accuracy compared to other equations for low LDL-C. It more accurately identifies high-risk patients, who are not at their LDL-C goals and could benefit from more intensive lipid-lowering therapy.

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来源期刊

Clinical chemistry 医学-医学实验技术

CiteScore

11.30

自引率

4.30%

发文量

212

审稿时长

1.7 months

期刊介绍： Clinical Chemistry is a peer-reviewed scientific journal that is the premier publication for the science and practice of clinical laboratory medicine. It was established in 1955 and is associated with the Association for Diagnostics & Laboratory Medicine (ADLM). The journal focuses on laboratory diagnosis and management of patients, and has expanded to include other clinical laboratory disciplines such as genomics, hematology, microbiology, and toxicology. It also publishes articles relevant to clinical specialties including cardiology, endocrinology, gastroenterology, genetics, immunology, infectious diseases, maternal-fetal medicine, neurology, nutrition, oncology, and pediatrics. In addition to original research, editorials, and reviews, Clinical Chemistry features recurring sections such as clinical case studies, perspectives, podcasts, and Q&A articles. It has the highest impact factor among journals of clinical chemistry, laboratory medicine, pathology, analytical chemistry, transfusion medicine, and clinical microbiology. The journal is indexed in databases such as MEDLINE and Web of Science.