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Comparing different assessments of remnant lipoprotein cholesterol: The very large database of lipids.
Journal of Clinical Lipidology ( IF 4.4 ) Pub Date : 2019-06-11 , DOI: 10.1016/j.jacl.2019.06.001
Kamil F Faridi 1 , Renato Quispe 2 , Seth S Martin 2 , Aditya D Hendrani 2 , Parag H Joshi 3 , Eliot A Brinton 4 , Daniel E Cruz 1 , Maciej Banach 5 , Peter P Toth 6 , Krishnaji Kulkarni 7 , Steven R Jones 2
Affiliation  

Background

Remnant lipoprotein cholesterol (RLP-C) is a risk factor for atherosclerotic cardiovascular disease, but there is no standard method for measurement. Some studies have used very low-density lipoprotein cholesterol estimated by the Friedewald equation to approximate RLP-C using a basic lipid panel, whereas others have attempted to measure RLP-C with ultracentrifugation.

Objective

The aim of the study was to compare RLP-C levels estimated from basic lipid parameters to those measured by ultracentrifugation.

Methods

We analyzed 1,350,908 individuals from the Very Large Database of Lipids, comparing one estimate of RLP-C using basic lipid parameters (RLP-Cestimated = non–high-density lipoprotein cholesterol − Friedewald-estimated low-density lipoprotein cholesterol for triglycerides <355 mg/dL [4 mmol/L], or non–high-density lipoprotein − directly measured low-density lipoprotein for triglycerides ≥355 mg/dL) to levels measured by vertical auto profile ultracentrifugation (RLP-Cmeasured = dense subfraction of very low-density lipoprotein cholesterol + intermediate-density lipoprotein cholesterol). We calculated correlations between RLP-Cestimated and RLP-Cmeasured along with median within-subject differences between RLP-Cestimated and RLP-Cmeasured across quintiles of RLP-Cestimated. We also assessed correlations with RLP-C estimated from basic lipid parameters using a novel method of calculating low-density lipoprotein cholesterol with a patient-specific conversion factor (RLP-Cestimated-N).

Results

Our cohort was 48% male, and median (interquartile range) age was 59 (49–69) years. Median (interquartile range) RLP-Cestimated and RLP-Cmeasured were 23 (16.4–33.2) and 24 (19–32) mg/dL, respectively. The correlation between RLP-Cestimated and RLP-Cmeasured was 0.76. Based on the specified definition of RLP-Cestimated, the correlation between RLP-Cestimated and triglyceride/5 for triglyceride < 355 mg/dL was exactly 1.0. RLP-Cestimated was lower than RLP-Cmeasured in the first and second quintiles of RLP-Cestimated but greater in the highest quintile. The correlations with RLP-Cestimated-N were 0.98 and 0.81 for RLP-Cestimated and RLP-Cmeasured, respectively.

Conclusions

A previously used estimate of RLP-C using basic lipid parameters correlates weakly with remnants measured by ultracentrifugation. Our findings emphasize the need to standardize definitions and measurements of RLP-C.



中文翻译:

比较残余脂蛋白胆固醇的不同评估:非常大的脂质数据库。

背景

残留的脂蛋白胆固醇(RLP-C)是动脉粥样硬化性心血管疾病的危险因素,但是没有标准的测量方法。一些研究使用Friedewald方程估算的极低密度脂蛋白胆固醇,使用基本脂质板来近似RLP-C,而其他研究则尝试通过超速离心法测量RLP-C。

客观的

该研究的目的是将根据基本脂质参数估算的RLP-C水平与通过超速离心法测得的RLP-C水平进行比较。

方法

我们分析了超大型脂质数据库中的1,350,908个人,比较了使用基本脂质参数对RLP-C的一种估计(RLP-C估计 =非高密度脂蛋白胆固醇–弗里德瓦尔德估计的低密度脂蛋白胆固醇,甘油三酯<355 mg / dL的[4毫摩尔/ L],或非高密度脂蛋白-甘油三酯≥355毫克/分升直接测量低密度脂蛋白)由垂直轮廓汽车超速离心测量水平(RLP-C测量 =非常低的致密的亚-密度脂蛋白胆固醇+中密度脂蛋白胆固醇)。RLP-C之间我们计算的相关性估计和RLP-C测定中位受试者内差异沿之间RLP-C估计和RLP-C在RLP-C估计值的五分位数中测得。我们还使用一种新的计算低密度脂蛋白胆固醇的新方法评估了与基础脂参数估计的RLP-C的相关性,该新方法使用了患者特定的转化因子(RLP-C估计-N)。

结果

我们的队列中男性为48%,中位(四分位间距)年龄为59(49-69)岁。估计的RLP-C中位数(四分位数范围)和测得的RLP-C分别为23(16.4–33.2)和24(19–32)mg / dL。估计的RLP-C与测得的RLP-C之间的相关性为0.76。根据RLP-C估计值的特定定义,对于甘油三酯<355 mg / dL ,RLP-C估计值与甘油三酸酯/ 5之间的相关性恰好为1.0。RLP-C估计比RLP-C下测得的在RLP-C的第一和第二五分位数估计,但大于在最高的五分之一。与RLP-C估计值N的相关性估计的RLP-C和测得的RLP-C分别为0.98和0.81 。

结论

以前使用的基本脂质参数对RLP-C的估计与通过超速离心法测得的残留物之间的相关性很弱。我们的发现强调需要标准化RLP-C的定义和测量。

更新日期:2019-06-11
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