Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Canton, Guangdong Province, China.
PeerJ. 2024 Oct 4;12:e18224. doi: 10.7717/peerj.18224. eCollection 2024.
Cholestasis is characterized by the accumulation of bile in the liver or biliary system due to obstruction or impaired flow, necessitating lipid profiling to assess lipid metabolism abnormalities. Intrahepatic cholestasis, being the most significant type of cholestasis, further complicates the assessment of lipid abnormalities. However, the accuracy of low-density lipoprotein cholesterol (LDL-C) measurement in intrahepatic cholestasis patients remains uncertain.
This study aimed to evaluate the consistency of the homogeneous assay and the Friedewald formula in detecting LDL-C levels and identify factors influencing LDL-C test results in intrahepatic patients with cholestasis.
Retrospective analysis of laboratory data was conducted on intrahepatic cholestatic patients. Correlations between LDL-C values obtained using the homogeneous method (LDL-C(D)) and the Friedewald formula (LDL-C(F)), as well as associations between high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (ApoA1), LDL-C(D) and LDL-C(F), and apolipoprotein B (ApoB), were analyzed. Logistic regression analyses were employed to identify diagnostic indicators for inaccurate LDL-C measurements in intrahepatic cholestatic patients.
Compared to patients with intrahepatic cholestasis without jaundice, the correlation between LDL-C(F) and LDL-C(D) was weaker in those with jaundice. Additionally, HDL-C exhibited a strong correlation with ApoA1 in both jaundice and non-jaundice cholestasis cases. Elevated non-HDL-C to APOB ratio (NH-C/B Ratio) levels (>4.5) were identified as a reliable predictor of inaccurate LDL-C measurements in patients with chronic intrahepatic cholestasis accompanied by jaundice.
LDL-C measurement reliability is moderately weaker in patients with intrahepatic cholestasis accompanied by jaundice. Elevated levels of the NH-C/B ratio serve as a significant predictor of inaccurate LDL-C measurements in this chronic patient population, highlighting its clinical relevance for diagnostic assessments.
胆汁淤积症的特征是由于阻塞或流动受损，导致胆汁在肝脏或胆道系统中积聚，需要进行脂质分析以评估脂质代谢异常。肝内胆汁淤积症是最常见的胆汁淤积症类型，进一步增加了脂质异常评估的复杂性。然而，在肝内胆汁淤积症患者中，低密度脂蛋白胆固醇（LDL-C）的测量准确性仍不确定。
本研究旨在评估均相测定法和 Friedewald 公式在检测 LDL-C 水平方面的一致性，并确定影响肝内胆汁淤积症患者 LDL-C 检测结果的因素。
对肝内胆汁淤积症患者进行实验室数据的回顾性分析。分析了使用均相法（LDL-C(D))和 Friedewald 公式（LDL-C(F))获得的 LDL-C 值之间的相关性，以及高密度脂蛋白胆固醇（HDL-C)和载脂蛋白 A1（ApoA1)、LDL-C(D)和 LDL-C(F)以及载脂蛋白 B（ApoB)之间的相关性。采用 logistic 回归分析确定肝内胆汁淤积症患者 LDL-C 测量不准确的诊断指标。
与无黄疸的肝内胆汁淤积症患者相比，有黄疸的患者 LDL-C(F)与 LDL-C(D)之间的相关性较弱。此外，在黄疸和非黄疸胆汁淤积症患者中，HDL-C 与 ApoA1 之间存在较强的相关性。非高密度脂蛋白胆固醇/载脂蛋白 B 比值（NH-C/B Ratio）升高（>4.5）被确定为伴有黄疸的慢性肝内胆汁淤积症患者 LDL-C 测量不准确的可靠预测指标。
伴有黄疸的肝内胆汁淤积症患者 LDL-C 测量的可靠性较弱。NH-C/B 比值升高是该慢性患者人群 LDL-C 测量不准确的重要预测指标，提示其在诊断评估中的临床相关性。
