Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Lipids Health Dis. 2012 Aug 31;11:107. doi: 10.1186/1476-511X-11-107.
To compare the predictive ability of adolescent lipoprotein classification using the National Examination Survey (NHANES) cut points and those of the National Cholesterol Education Program (NCEP) for predicting abnormal levels in adulthood.
From 1032 adolescents, aged 14-19 years, participants of the Tehran Lipid and Glucose Study, all lipid measures were determined at baseline and again after 6 years. Multivariable Odds Ratios (ORs) were calculated for borderline and high categories of lipids to predict dyslipidemia in adulthood, considering the normal level as a reference. Area under the receiving characteristics curve (AUC) was used to assess the predictive ability of each adolescent lipid classification.
Applying the NCEP classification, the prevalences of high total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides and low high density lipoprotein cholesterol (HDL-C) in males were 12.1%, 12.9%, 26.1% and 34.2% respectively; in females the corresponding prevalences were 15.4%, 17.9%, 21.4% and 25.0%, respectively. Using NHANES cut points, the prevalence of high TC, LDL-C and triglycerides were lower, than those defined by NCEP; the ORs of high categories of lipids (defined by NHANES) were higher than ORs based on the NECP classification, except for HDL-C. For all lipid measures, both classifications had similar predictive abilities, except for TC/HDL-C, which had higher predictive power applying the NHANES classification rather than the NCEP one (AUC 71% vs. 68%, respectively).
No differences were found between NCEP and NHANES classifications for prediction of adult dyslipidemia, except for TC/HDL-C. Because of their simple application, NCEP cut points can be used in clinical settings.
比较青少年脂蛋白分类使用国家考试调查（NHANES）切点和国家胆固醇教育计划（NCEP）预测成年异常水平的能力。
从 1032 名年龄在 14-19 岁的德黑兰血脂和血糖研究参与者中，在基线和 6 年后再次测定所有血脂指标。采用多变量比值比（OR）来计算边缘和高脂质类别的血脂，以预测成年期血脂异常，以正常水平为参考。接受特征曲线下面积（AUC）用于评估每个青少年脂质分类的预测能力。
应用 NCEP 分类，男性高总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯和低高密度脂蛋白胆固醇（HDL-C）的患病率分别为 12.1%、12.9%、26.1%和 34.2%；女性相应的患病率分别为 15.4%、17.9%、21.4%和 25.0%。使用 NHANES 切点，高 TC、LDL-C 和甘油三酯的患病率低于 NCEP 定义的患病率；高脂质类别的 ORs（由 NHANES 定义）高于基于 NECP 分类的 ORs，除了 HDL-C。对于所有血脂指标，两种分类方法的预测能力相似，除了 TC/HDL-C，应用 NHANES 分类比 NCEP 分类具有更高的预测能力（AUC 分别为 71%和 68%）。
NCEP 和 NHANES 分类在预测成年血脂异常方面没有差异，除了 TC/HDL-C。由于它们的简单应用，NCEP 切点可以在临床环境中使用。
