Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria and National Health Laboratory Service Tshwane Academic Division, Pretoria, South Africa.
Division of Chemical Pathology, University of Cape Town, Pretoria, South Africa.
Clin Chem Lab Med. 2021 Aug 12;59(12):1930-1943. doi: 10.1515/cclm-2021-0747. Print 2021 Nov 25.
Low-density lipoprotein cholesterol (LDL-C) estimation is critical for risk classification, prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). Predictive equations and direct LDL-C are used. We investigated the comparability between the Martin/Hopkins, Sampson, Friedewald and eight other predictive equations on two analysers, to determine whether the equation or analyser influences predicted LDL-C result.
In two unpaired datasets, 9,995 lipid profiles were analysed by the Abbott Architect and 4,782 by the Roche Cobas analysers. Non-parametric statistics and Bland Altman plots were used to compare LDL-C.
On the Abbott analyser; the Martin/Hopkins, Sampson and Friedewald LDL-C were comparable (median bias ≤1.8%) over a range of 1-4.9 mmol/L. On the Roche platform, Martin/Hopkins LDL-C was comparable to Friedewald (median bias 0.3%) but not to Sampson LDL-C (median bias 25%). In patients with LDL-C <1.8 mmol/L and triglycerides (TG) ≤1.7 mmol/L, predicted LDL-C using Abbott reagents was similar between Martin/Hopkins, Sampson and Friedewald equations but not comparable using Roche reagents. Abbott reagents classified 10-20% of patients in the 1.0-1.8 mmol/L range (Martin/Hopkins 13.4%; Sampson 14.5%; Friedewald 16%; direct LDL-C 13.2%). Roche reagents classified 11-30% in the 1.0-1.8 mmol/L range (Martin/Hopkins 23%; Sampson 11%; Friedewald 25%; direct LDL-C 17%).
Performance of predictive equations is influenced by the choice of analyser for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and TG. Replacement of the Friedewald equation with Martin/Hopkins estimation to improve quality of LDL-C results can be safely implemented across analysers, whereas caution is advised regarding the Sampson equation.
低密度脂蛋白胆固醇（LDL-C）的估测对于动脉粥样硬化性心血管疾病（ASCVD）的危险分层、预防和治疗至关重要。可使用预测方程和直接 LDL-C。我们研究了两种分析仪上的 Martin/Hopkins、Sampson、Friedewald 以及其他 8 种预测方程之间的可比性，以确定是方程还是分析仪影响预测的 LDL-C 结果。
在两个非配对数据集里，用 Abbott Architect 分析仪分析了 9995 份血脂谱，用 Roche Cobas 分析仪分析了 4782 份血脂谱。使用非参数统计和 Bland-Altman 图来比较 LDL-C。
在 Abbott 分析仪上，Martin/Hopkins、Sampson 和 Friedewald 的 LDL-C 在 1-4.9mmol/L 范围内具有可比性（中位数偏差≤1.8%）。在 Roche 平台上，Martin/Hopkins 的 LDL-C 与 Friedewald 的 LDL-C 可比（中位数偏差 0.3%），但与 Sampson 的 LDL-C 不可比（中位数偏差 25%）。在 LDL-C<1.8mmol/L 且甘油三酯（TG）≤1.7mmol/L 的患者中，Abbott 试剂的 Martin/Hopkins、Sampson 和 Friedewald 方程预测的 LDL-C 相似，但 Roche 试剂不可比。Abbott 试剂将 10-20%的患者归类为 1.0-1.8mmol/L 范围（Martin/Hopkins 为 13.4%；Sampson 为 14.5%；Friedewald 为 16%；直接 LDL-C 为 13.2%）。Roche 试剂将 11-30%的患者归类为 1.0-1.8mmol/L 范围（Martin/Hopkins 为 23%；Sampson 为 11%；Friedewald 为 25%；直接 LDL-C 为 17%）。
用于总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和 TG 的分析仪的选择会影响预测方程的性能。可以在分析仪之间安全地用 Martin/Hopkins 估计来替代 Friedewald 方程以改善 LDL-C 结果的质量，而对于 Sampson 方程则需要谨慎。
