Mogadam M, Ahmed S W, Mensch A H, Godwin I D
Georgetown University School of Medicine, Washington, DC.
Arch Intern Med. 1990 Aug;150(8):1645-8.
The National Cholesterol Education Program has begun a National Campaign to screen millions of adult Americans for serum cholesterol. To determine whether such random samples represent an individual's true lipoprotein status, we measured fasting total serum cholesterol and lipoproteins, on a weekly basis for 4 weeks, in 20 subjects ages 22 to 63 years. Duplicate samples were tested by two standardized laboratories, each on five consecutive days. Variations of more than +/- 20% in the serum levels of total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were seen in 75%, 95%, and 65% of the subjects, respectively. On retesting, 40% of the subjects moved in or out of one "risk category"; and in 10% two categories, from "desirable" to "high risk," or vice versa. These data demonstrate that random testing may fall to detect wide fluctuations in the levels of serum lipoproteins, and therefore result in erroneous risk assignment or therapeutic intervention.
国家胆固醇教育计划已启动一项全国性运动，对数百万美国成年民众进行血清胆固醇筛查。为了确定此类随机样本是否代表个体的真实脂蛋白状况，我们对20名年龄在22至63岁之间的受试者，连续4周每周测量其空腹血清总胆固醇和脂蛋白。重复样本由两个标准化实验室检测，每个实验室连续检测五天。分别有75%、95%和65%的受试者血清总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平变化超过±20%。再次检测时，40%的受试者进入或移出一个“风险类别”；10%的受试者进入或移出两个类别，从“理想”变为“高风险”，或反之。这些数据表明，随机检测可能无法检测出血清脂蛋白水平的大幅波动，从而导致错误的风险判定或治疗干预。
