Gidding S S, Stone N J, Bookstein L C, Laskarzewski P M, Stein E A
Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois, USA.
J Pediatr. 1998 Aug;133(2):242-6. doi: 10.1016/s0022-3476(98)70227-6.
To assess month-to-month variability of total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), calculated low-density lipoprotein-cholesterol (LDL-C), apolipoprotein A1, apolipoprotein B, and lipoprotein (a), as well as factors that could influence variability, including recent acute infection in an adolescent population.
Sixty-three high school students had fasting lipids and lipoproteins measured at 4 separate times during the school year and another venipuncture 3 to 7 days after recovery from an acute infection. Erythrocyte sedimentation rate was also measured. Coefficients of variation were calculated for each study variable. The influence of recent infection on variability was assessed.
The 50th and 95th percentiles, respectively, for the coefficient of variation for each variable were as follows: total cholesterol, 7.3% and 13.6%; triglycerides, 22% and 47.3%; HDL-C, 7.9% and 16.8%; LDL-C, 12.1% and 25%; apolipoprotein A1, 6.3% and 15.2%; apolipoprotein B, 9.5% and 17.2%; and lipoprotein (a), 19.3% and 40%. Recent infection significantly lowered HDL-C (4 mg/dL; P < .0001) and apolipoprotein A1 (7 mg/dL; P < .005).
Clinicians evaluating lipids and lipoproteins serially should expect significant visit-to-visit variation in triglycerides and calculated LDL-C values. Assessment of HDL-C and apolipoprotein A1 should not be done within 2 weeks of an acute infection. Apolipoproteins B and A1 have slightly less variability than their respective lipoprotein cholesterol values (LDL-C and HDL-C).
评估青少年群体中总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-C）、计算得出的低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1、载脂蛋白B和脂蛋白(a)的逐月变异性，以及可能影响变异性的因素，包括近期急性感染情况。
63名高中生在学年期间分4次测量空腹血脂和脂蛋白，并在急性感染康复后3至7天进行另一次静脉穿刺采血。同时测量红细胞沉降率。计算每个研究变量的变异系数。评估近期感染对变异性的影响。
各变量变异系数的第50百分位数和第95百分位数分别如下：总胆固醇，7.3%和13.6%；甘油三酯，22%和47.3%；HDL-C，7.9%和16.8%；LDL-C，12.1%和25%；载脂蛋白A1，6.3%和15.2%；载脂蛋白B，9.5%和17.2%；脂蛋白(a)，19.3%和40%。近期感染显著降低了HDL-C（4mg/dL；P<.0001）和载脂蛋白A1（7mg/dL；P<.005）。
连续评估血脂和脂蛋白的临床医生应预期甘油三酯和计算得出的LDL-C值在每次就诊时会有显著变化。急性感染后2周内不应评估HDL-C和载脂蛋白A1。载脂蛋白B和A1的变异性略低于其各自的脂蛋白胆固醇值（LDL-C和HDL-C）。
