Paz Eduardo, Hermida Jesús, Bouzas Lorena, Brenlla Julio, Tutor J Carlos
Hospital Psiquíatrico de Conxo, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Clin Biochem. 2008 Aug;41(12):1002-7. doi: 10.1016/j.clinbiochem.2008.04.017. Epub 2008 Apr 27.
The use of new antipsychotic drugs is associated with an increased risk of diabetes and metabolic syndrome, and the routine monitoring of blood lipids during treatment has been recommended. Recently, a new formula for the estimation of low-density lipoprotein (LDL) cholesterol from total cholesterol and triglycerides has been proposed by Anandaraja et al. (Int J Cardiol 2005; 102: 117), and the aim of our study was its evaluation in schizophrenic patients treated with antipsychotic drugs.
In 487 serum samples from schizophrenic patients treated with clozapine in polytherapy, the concentrations of LDL cholesterol were determined by agar gel electrophoresis and the formula of Friedewald et al. (Clin Chem 1972; 18: 499), and compared with the results of the Anandaraja's formula.
A higher correlation and lower error of the estimate of the electrophoresis results was found with those of Friedewald (r=0.940, ma68=0.17 mmol/L) than those of Anandaraja (r=0.811, ma68=0.31 mmol/L). Similar results were obtained on making a dichotomy of the patients with and without metabolic syndrome lipid profile. A highly significant correlation was found between the high-density lipoprotein (HDL) cholesterol levels and the Anandaraja/Electrophoresis (r=0.817, p<0.001) and Anandaraja/Friedewald (r=0.977, p<0.001) ratios.
According to our data, Anandaraja's formula tends towards an overestimation or underestimation of LDL cholesterol levels, depending on whether the HDL cholesterol levels are high or low, which may be clinically significant. These results do not support the proposed better accuracy of the Anandaraja's than the Friedewald's formula.
新型抗精神病药物的使用与糖尿病和代谢综合征风险增加相关，因此建议在治疗期间常规监测血脂。最近，阿南达拉贾等人提出了一种根据总胆固醇和甘油三酯估算低密度脂蛋白（LDL）胆固醇的新公式（《国际心脏病学杂志》2005年；102:117），我们研究的目的是在接受抗精神病药物治疗的精神分裂症患者中对其进行评估。
在487份接受氯氮平联合治疗的精神分裂症患者的血清样本中，采用琼脂凝胶电泳法和弗里德瓦尔德等人的公式（《临床化学》1972年；18:499）测定LDL胆固醇浓度，并与阿南达拉贾公式的结果进行比较。
与阿南达拉贾公式的结果相比，弗里德瓦尔德公式的电泳结果与之具有更高的相关性和更低的估算误差（r = 0.940，平均绝对偏差 = 0.17 mmol/L），而阿南达拉贾公式的结果相关性为r = 0.811，平均绝对偏差 = 0.31 mmol/L。对有或无代谢综合征血脂谱的患者进行二分法分析时也得到了类似结果。发现高密度脂蛋白（HDL）胆固醇水平与阿南达拉贾公式/电泳法（r = 0.817，p < 0.001）以及阿南达拉贾公式/弗里德瓦尔德公式（r = 0.977，p < 0.001）的比值之间存在高度显著的相关性。
根据我们的数据，阿南达拉贾公式往往会高估或低估LDL胆固醇水平，这取决于HDL胆固醇水平是高还是低，这可能具有临床意义。这些结果不支持阿南达拉贾公式比弗里德瓦尔德公式具有更高准确性的说法。
