Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
J Appl Lab Med. 2024 Sep 3;9(5):1040-1056. doi: 10.1093/jalm/jfae057.
The accurate measurement of blood lipids and lipoproteins is crucial for the clinical management of atherosclerotic disease risk. Despite progress in standardization, there are still significant variations in pre-analytical requirements, methods, nomenclature, and reporting work flows.
The guidance document aims to improve standardization of clinical lipid testing work flows. It provides recommendations for the components of the lipid panel, fasting requirements, reporting of results, and specific recommendations for non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], apolipoprotein B (apo B), point-of-care lipid testing, and LDL subfraction testing.
Lipid panels should always report non-HDL-C and LDL-C calculations if possible. Fasting is not routinely required except in specific cases. Modern equations should be utilized for LDL-C calculation. These equations allow for LDL-C reporting at elevated concentrations of triglycerides and obviate the need for direct measured LDL-C in most cases.
准确测量血脂和脂蛋白对于动脉粥样硬化疾病风险的临床管理至关重要。尽管在标准化方面取得了进展，但在分析前要求、方法、命名和报告工作流程方面仍存在显著差异。
本指导文件旨在提高临床脂质检测工作流程的标准化。它为脂质谱的组成部分、禁食要求、结果报告以及非高密度脂蛋白胆固醇（非-HDL-C）、低密度脂蛋白胆固醇（LDL-C）、脂蛋白（a）[Lp(a)]、载脂蛋白 B（apo B）、即时检测脂质和 LDL 亚组分检测提供了建议。
如果可能，脂质谱应始终报告非-HDL-C 和 LDL-C 计算值。除非在特定情况下，通常不需要禁食。应使用现代方程进行 LDL-C 计算。这些方程允许在甘油三酯浓度升高时报告 LDL-C，并在大多数情况下消除了对直接测量 LDL-C 的需求。
