Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
Lipids and Cardiovascular Risk Service, Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Ann Clin Biochem. 2024 May;61(3):195-203. doi: 10.1177/00045632231210682. Epub 2023 Nov 8.
Lipoprotein(a) (Lp(a)) is now established as a causal risk factor for cardiovascular disease (CVD) and accurate laboratory measurement is of pivotal importance in reducing Lp(a) associated risk. The consensus statement by HEART UK in 2019 included recommendations to improve standardisation of clinical laboratory measurement and reporting of Lp(a).
A 16 question, electronic audit survey was circulated to 190 accredited clinical biochemistry laboratories to assess the adoption of these recommendations in the UK.
Responses were received from 65 of 190 laboratories (34%). Only 5 (8%) did not offer Lp(a) measurement. Of those providing the test, 23% (n = 14) offered an in-house service (IHS), the remaining laboratories (77%; n = 46) used an external referral service (ERS). The majority (10 of 14 or 71%) of IHS laboratories responded with details of their method, stating whether it minimised sensitivity to the effect of Lp(a) isoform size and used calibrators certified for traceability to the WHO/IFCC reference material, however, only a minority ERS laboratories (13 of the 46 or 28%) were able to specify the method used by their referral laboratory. Of the laboratories who specified their reporting units, 6 of 10 IHS and 7 of 23 ERS laboratories reported in nmol/L. Among the 60 laboratories who responded, the HEART UK recommendations appear to have been adopted in full by only 3 IHS laboratories.
Further efforts are needed to standardise the measurement and reporting of Lp(a) so that results and interpretation are comparable across clinical biochemistry laboratories in the UK.
脂蛋白(a)（Lp(a)）现已被确定为心血管疾病（CVD）的致病危险因素，准确的实验室测量对于降低 Lp(a)相关风险至关重要。2019 年英国心脏协会（HEART UK）的共识声明包括改善临床实验室测量和报告 Lp(a)的标准化的建议。
向 190 家经过认证的临床生物化学实验室分发了一份 16 个问题的电子审计调查，以评估这些建议在英国的采用情况。
从 190 家实验室中收到了 65 家（34%）的回复。只有 5 家（8%）实验室不提供 Lp(a)测量。在提供该检测的实验室中，23%（n=14）提供内部服务（IHS），其余实验室（77%；n=46）使用外部转介服务（ERS）。大多数（14 家中的 10 家或 71%）IHS 实验室提供了其方法的详细信息，说明其是否最小化了对 Lp(a)同工型大小的敏感性，并使用经认证可溯源至世界卫生组织/国际临床化学联合会参考物质的校准器，但只有少数 ERS 实验室（46 家实验室中的 13 家或 28%）能够指定其转介实验室使用的方法。在指定报告单位的实验室中，10 家 IHS 实验室中的 6 家和 23 家 ERS 实验室中的 7 家以 nmol/L 报告。在做出回应的 60 家实验室中，只有 3 家 IHS 实验室完全采用了英国心脏协会的建议。
需要进一步努力标准化 Lp(a)的测量和报告，以便英国临床生物化学实验室的结果和解释具有可比性。
