Fatima Safia, Ijaz Aamir, Sharif Tariq Bin, Khan Dilshad Ahmad, Siddique Amer
Department of Chemical Pathology and Endocrinology, AFIP, Rawalpindi. (National University of Medical Sciences, Islamabad).
J Coll Physicians Surg Pak. 2016 Dec;26(12):954-957.
To determine the diagnostic accuracy of non-fasting lipid profile in the diagnosis of hyperlipidemia, taking fasting lipid profile as gold standard, in adult population.
Cross-sectional validation study.
Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from July to December 2014.
One hundred seventy-five adult patients coming for fasting lipid profile were included; their non-fasting samples were taken on the next day. Patients on anti-cholesterol treatment and indoor patients were excluded. Total cholesterol (TC), high density lipoprotein-cholestrol (HDL-C), and triglycerides were measured by direct enzymatic colorimetric method by Modular p-800®. Low density lipoprotein-cholesterol (LDL-C) was calculated by Friedewald's formula, but when triglyceride was greater than 4.5 mmol/l, then LDL-C was measured directly by homogenous enzymatic colorimetric method. Non-HDL-C was calculated by simple equation, i.e. TC-HDL-C.
Non-fasting lipid profile had 93% specificity , 51% sensitivity, 94% positive predictive value and 49% negative predictive value; and 65% accuracy with 7.28 positive likelihood ratio and 0.52 negative likelihood ratio. Non-fasting TC and non-HDL-C were significantly higher than fasting TC and non-HDL-C by mean difference of 0.2 mmol/l each with p=0.001 and p=0.004, respectively. Fasting and non fasting HDL-C are comparable to each other with mean difference of 0.01 mmol/l (p=0.745). Receiver operating curve (ROC) of non-fasting non-HDL-C showed 0.804 (95%CI (0.738-0.870), (p=0.000) area under the curve (AUC) indicating that it was a significant test for ruling out hyperlipidemia. Bland-Altmann plot showed a significant difference between non-fasting, non-HDL-C and fasting LDL-C and non-fasting, non-HDL-C -0.087540 with bias -0.00109; therefore, these cannot be alternative to each other.
Diagnostic accuracy of non-fasting lipid profile was found significantly higher than fasting lipid profile (p=0.004) for the assessment of lipoprotein coronary risk on the basis of non-HDL-C, which seemed to be significant test for ruling out hyperlipidemia.
以空腹血脂谱作为金标准，确定非空腹血脂谱在成人群体中诊断高脂血症的诊断准确性。
横断面验证研究。
2014年7月至12月，拉瓦尔品第武装部队病理研究所化学病理学和内分泌科。
纳入175名前来进行空腹血脂谱检测的成年患者；在第二天采集他们的非空腹样本。排除接受抗胆固醇治疗的患者和住院患者。总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯通过Modular p - 800®直接酶比色法测量。低密度脂蛋白胆固醇（LDL-C）通过Friedewald公式计算，但当甘油三酯大于4.5 mmol/l时，则通过均质酶比色法直接测量LDL-C。非高密度脂蛋白胆固醇（Non-HDL-C）通过简单公式计算，即TC - HDL-C。
非空腹血脂谱的特异性为93%，敏感性为51%，阳性预测值为94%，阴性预测值为49%；准确性为65%，阳性似然比为7.28，阴性似然比为0.52。非空腹TC和非空腹Non-HDL-C显著高于空腹TC和空腹Non-HDL-C，平均差异分别为0.2 mmol/l，p值分别为0.001和0.004。空腹和非空腹HDL-C彼此相当，平均差异为0.01 mmol/l（p = 0.745）。非空腹Non-HDL-C的受试者工作特征曲线（ROC）显示曲线下面积（AUC）为0.804（95%CI（0.738 - 0.870），（p = 0.000），表明它是排除高脂血症的一项显著检测。Bland-Altmann图显示非空腹Non-HDL-C与空腹LDL-C之间存在显著差异，非空腹Non-HDL-C为-0.087540，偏差为-0.00109；因此，它们不能相互替代。
基于非高密度脂蛋白胆固醇，在评估脂蛋白冠心病风险方面，发现非空腹血脂谱的诊断准确性显著高于空腹血脂谱（p = 0.004），非空腹血脂谱似乎是排除高脂血症的一项显著检测。
