Department of Chemical Pathology, Faculty of Health Sciences and National Health Laboratory Service, Tshwane Academic Division, University of Pretoria, Pretoria, South Africa.
Department of Chemical Pathology, Faculty of Health Sciences and National Health Laboratory Service, Tshwane Academic Division, University of Pretoria, Pretoria, South Africa; Division of Chemical Pathology, University of Cape Town, Cape Town, South Africa.
Clin Chim Acta. 2023 May 1;545:117373. doi: 10.1016/j.cca.2023.117373. Epub 2023 May 2.
The gold standard for measuring LDL-C is impractical and direct measurements have numerous shortcomings. Older predictive equations are used only with triglycerides (TG's) below 4.52 mmol/L. We evaluated the newer equations validated for use in hypertriglyceridaemia by comparison with direct LDL-C.
Datasets from two platforms (Abbott Architect and Roche Cobas) comprised of a large cohort of 64,765 individuals were used to compare the Sampson-National Institutes of Health 2 (S-NIH2) and Extended Martin-Hopkins (E-MH) equations for LDL-C with direct LDL-C (dLDL-C) assays.
With TG's of 4.52-9.04 mmol/L the S-NIH2 equation tended to calculate lower values than measured by dLDL-C and the E-MH equation calculated higher values. Both equations correlated better with the dLDL-C measured on Abbott than Roche with the E-MH equation having more values falling within acceptable concordance levels on both platforms.
The E-MH equation correlates better with dLDL-C than the S-NIH2 on both platforms with TG levels up to 9.04 mmol/L. With hypertriglyceridaemia, the E-MH equation is less likely than the S-NIH2 equation to underestimate LDL-C when compared to the dLDL-C and will be less likely to underdiagnose patients with LDL-C levels requiring treatment according to current guidelines.
测量 LDL-C 的金标准不切实际，直接测量有许多缺点。较旧的预测方程仅用于 TG 低于 4.52mmol/L 的情况。我们通过与直接 LDL-C 进行比较，评估了新的适用于高甘油三酯血症的验证方程。
使用来自两个平台（雅培 Architect 和罗氏 Cobas）的大型队列 64765 个人的数据集，比较了 Sampson-National Institutes of Health 2（S-NIH2）和扩展 Martin-Hopkins（E-MH）方程对 LDL-C 的计算值与直接 LDL-C（dLDL-C）检测值。
在 TG 为 4.52-9.04mmol/L 时，S-NIH2 方程倾向于计算出比 dLDL-C 测量值低的 LDL-C 值，而 E-MH 方程计算出的 LDL-C 值较高。两个方程与 Abbott 上的 dLDL-C 相关性更好，与 Roche 相比，E-MH 方程具有更多的测量值落在两个平台的可接受一致性水平内。
在 TG 水平高达 9.04mmol/L 时，E-MH 方程与 S-NIH2 相比，在两个平台上与 dLDL-C 的相关性更好。在高甘油三酯血症的情况下，与 dLDL-C 相比，E-MH 方程比 S-NIH2 方程更不可能低估 LDL-C，并且不太可能根据当前指南低估需要治疗的 LDL-C 水平的患者。
