What have we learnt about high-density lipoprotein cholesterol measurements during 32 years? Experiences in Finland 1980-2012

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• 作者：Jaana Leiviskä ; ^a ; ^{jaana.leiviska@thl.fi} ; Jouko Sundvall^a ; Georg Alfthan^a ; Riitta Tä ; htelä ; ^b ; Veikko Salomaa^a ; Matti Jauhiainen^a ; ^c ; Erkki Vartiainen^d
• 关键词：HDL ; high-density lipoprotein ; HDL-C ; HDL cholesterol ; EQA ; external quality assessment ; LDL ; low-density lipoprotein ; LDL-C ; LDL cholesterol ; RCT ; reverse cholesterol transport ; VLDL ; very low-density lipoprotein ; apoA-I ; apolipoprotein A-I ; apoB ; apolip
• 刊名：Clinica Chimica Acta
• 出版年：2013
• 出版时间：16 January, 2013
• 年：2013
• 卷：415
• 期：Complete
• 页码：118-123
• 全文大小：416 K

文摘

Background

High-density lipoprotein cholesterol (HDL-C) is important in risk assessment for cardiovascular disease or metabolic syndrome; however, different direct HDL-C assays may lead to erroneous risk estimates and potentially misclassify people.

Methods

Data for 30-year HDL-C trends in Finland were obtained from the national FINRISK surveys during 1982-2012 (n = 45 766) taking into account biases from three external quality assessment programs (EQA). We also compared two different direct HDL-C and turbidimetric apolipoprotein A-I methods using 413 fresh serum samples.

Results

HDL-C concentrations in the Finnish population were on average 1.33 (¡À 0.04) mmol/l for men and 1.62 (¡À 0.05) mmol/l for women after bias-correction. Positive HDL-C trends were observed for both sexes with original data, but trends disappeared after bias-correction. Comparison of two direct HDL-C methods demonstrated concentration-dependent difference. When HDL-C concentrations were < 1.0 mmol/l, the mean bias was ? 12.0 % (95 % CI ? 13.5 to ? 10.0) whereas HDL-C concentrations > 1.55 mmol/l showed mean bias of 9.0 % (95 % CI 7.0-10.5).

Conclusions

Accurate reporting of HDL-C concentrations at the population level requires proper and regular attendance to reliable EQA programs. We found evidence for a concentration-dependent difference between some direct HDL-C methods, which may cause misclassification of people in cardiovascular risk assessment.