糖尿病或服用降脂药物患者的计算低密度脂蛋白胆固醇与直接测量低密度脂蛋白胆固醇的差异。

Difference between calculated and direct-measured low-density lipoprotein cholesterol in subjects with diabetes mellitus or taking lipid-lowering medications.

机构信息

Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 135-984, Republic of Korea.

出版信息

J Clin Lipidol. 2012 Mar-Apr;6(2):114-20. doi: 10.1016/j.jacl.2011.12.007. Epub 2011 Dec 23.

DOI:10.1016/j.jacl.2011.12.007

PMID:22385544

Abstract

OBJECTIVE

We evaluated factors that caused differences between calculated low-density lipoprotein cholesterol (C-LDL-C) and direct-measured LDL-C (D-LDL-C) and compared them in subjects with diabetes mellitus (DM) or taking lipid-lowering medications.

METHODS

21,452 subjects (9,177 women, 12,275 men; 8.1% with DM and 8.5% on lipid-lowering medications) were included in the analysis. Participants were classified into 3 groups, i.e., group 1: the subjects without DM and not on lipid-modifying drugs (n = 18,287), group 2: without DM and on lipid-modifying drugs (n = 1,423), and group 3: with DM (n = 1,742). LDL-C concentrations were either directly measured by a homogenous method or calculated by Friedewald formula.

RESULTS

There was a significant correlation between C-LDL-C and D-LDL-C (r = 0.966, P < .001). The absolute values of the differences between two LDL-C values were 7.0 ± 6.2 mg/dl and 6.6 ± 7.3% (6.6 ± 5.9 mg/dl and 6.0 ± 6.5%, 8.8 ± 6.7 mg/dl and 9.1 ± 9.7%, and 10.1 ± 7.3 mg/dl and 10.7 ± 10.1% in group 1, 2, and 3 respectively, P < .001). The subjects with the absolute value of the differences of LDL-C ≥10% was 20.2% (17.3%, 31.3%, and 41.1% in group 1, 2, and 3 respectively, P < .001). In the multiple logistic regression analysis, high triglyceride (≥150 mg/dl), low high-density lipoprotein cholesterol (HDL-C) (<40 mg/dl), male gender, obesity (body mass index ≥25 kg/m(2)), DM and taking lipid-lowering drugs were significant associated with high LDL-differences (the absolute value of the differences ≥10% or ≥10 mg/dl).

CONCLUSION

D-LDL-C was generally higher by 5 mg/dl or 5% than C-LDL-C. The differences C-LDL-C and D-LDL-C were higher in subjects with DM and on lipid-lowering medications. Male gender, high triglyceride, low HDL-C, and obesity were also associated with the greater differences between C-LDL-C and D-LDL-C.

摘要

目的

我们评估了导致计算低密度脂蛋白胆固醇（C-LDL-C）与直接测量 LDL-C（D-LDL-C）之间差异的因素，并在患有糖尿病（DM）或服用降脂药物的患者中对这些因素进行了比较。

方法

共纳入 21452 名受试者（女性 9177 名，男性 12275 名；8.1%患有 DM，8.5%服用降脂药物）。受试者被分为 3 组：第 1 组：无 DM 且未服用调脂药物的受试者（n=18287），第 2 组：无 DM 但服用调脂药物的受试者（n=1423），第 3 组：患有 DM 的受试者（n=1742）。LDL-C 浓度通过均相法直接测量或通过 Friedewald 公式计算。

结果

C-LDL-C 与 D-LDL-C 呈显著相关（r=0.966，P<0.001）。两种 LDL-C 值之间的差值绝对值分别为 7.0±6.2mg/dl 和 6.6±7.3%（6.6±5.9mg/dl 和 6.0±6.5%，6.8±6.7mg/dl 和 6.1±6.5%，10.1±7.3mg/dl 和 10.7±10.1%，在第 1、2 和 3 组中，P<0.001）。LDL-C 差值绝对值≥10%的受试者占 20.2%（17.3%、31.3%和 41.1%，在第 1、2 和 3 组中，P<0.001）。多元逻辑回归分析显示，高甘油三酯（≥150mg/dl）、低高密度脂蛋白胆固醇（HDL-C）（<40mg/dl）、男性、肥胖（体重指数≥25kg/m²）、DM 和服用降脂药物与 LDL-C 差值较大（差值绝对值≥10%或≥10mg/dl）显著相关。