新颖的胆固醇计算方法也许能避免禁食
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By LabMedica International staff writers Posted on 07 Mar 2018 |
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图片：准确的新型胆固醇检验也许能让患者跳过禁食环节（图片蒙约翰霍普金斯大学医学院惠赐）。
科学家开展了一项直接比较研究，得到的证据进一步证实了一个结论：一种更新的计算低密度脂蛋白胆固醇水平的方法应用于非空腹抽血的患者时比旧方法更准确。
最近的建议倾向于估计非空腹状态下的脂质水平，这也许会影响低密度脂蛋白胆固醇(LDL-C)的估值。上述估计LDL-C的新方法(LDL-CN)用一种灵活的方法得出患者特有的甘油三酯(TG)与极低密度脂蛋白-胆固醇的比值。
美国马里兰州巴尔的摩市约翰霍普金斯大学医学院)的血脂专家及其同事使用美国超大规模脂质数据库第二批数据集中1,545,634名患者（959,153人空腹≥10-12小时；586,481人未空腹）的切片样本，首次评估了空腹状态对LDL-C新估值法准确性的影响。他们用超速离心法直接测量LDL胆固醇的内容(LDL-CD)。准确度定义为LDL-CD的临床截值落在LDL-C新估值方法(LDL-CN)范围内的百分比或落在经典弗里德瓦尔德(Friedewald)方法(LDL-CF)范围内的百分比。对于较小的LDL-C估值 (<70毫克/分升)，他们通过TG水平评估准确度。根据LDL-C和TG类型对LDL-CD与LDL-C估值(LDL-CN或LDL-CF)之间差异的绝对值和百分比值进行分级。
科学家报道，所有临床LDL-C类型的空腹样本和非空腹样本用新方法的准确度（范围：87-94%）都高于弗里德瓦尔德估值法（范围：71-93%）。用弗里德瓦尔德方法时，约30%的非空腹参与者胆固醇测量值的误差大于10毫克/分升，而新方法与实际测量值只有3%的误差。研究人员报道，计算LDL的整体准确度随甘油三酯水平的升高而下降，尤其是当使用弗里德瓦尔德方法时。例如，6,168名甘油三酯水平在200到399毫克/分升之间的非空腹参与者中，用新方法计算LDL小于70毫克/分升者的准确度是82%，而用弗里德瓦尔德方法的准确度是37%。
该研究的论文发表于2018年1月2日的《循环》(Circulation)杂志。论文资深作者、医学助理教授Seth Shay Martin大夫说：“虽然计算LDL的新方法有点复杂，但妙处在于可以用已包含在血样中的信息执行该方法，求得标准的脂质特征谱，并可在实验室计算机系统内自动执行，给出更准确的结果。因为非空腹样本现在变得准确，病人可以随时来做检查，就算已吃过也无需再重新约，所以对病人来说更加方便。”
Related Links:
约翰霍普金斯大学医学院
最近的建议倾向于估计非空腹状态下的脂质水平，这也许会影响低密度脂蛋白胆固醇(LDL-C)的估值。上述估计LDL-C的新方法(LDL-CN)用一种灵活的方法得出患者特有的甘油三酯(TG)与极低密度脂蛋白-胆固醇的比值。
美国马里兰州巴尔的摩市约翰霍普金斯大学医学院)的血脂专家及其同事使用美国超大规模脂质数据库第二批数据集中1,545,634名患者（959,153人空腹≥10-12小时；586,481人未空腹）的切片样本，首次评估了空腹状态对LDL-C新估值法准确性的影响。他们用超速离心法直接测量LDL胆固醇的内容(LDL-CD)。准确度定义为LDL-CD的临床截值落在LDL-C新估值方法(LDL-CN)范围内的百分比或落在经典弗里德瓦尔德(Friedewald)方法(LDL-CF)范围内的百分比。对于较小的LDL-C估值 (<70毫克/分升)，他们通过TG水平评估准确度。根据LDL-C和TG类型对LDL-CD与LDL-C估值(LDL-CN或LDL-CF)之间差异的绝对值和百分比值进行分级。
科学家报道，所有临床LDL-C类型的空腹样本和非空腹样本用新方法的准确度（范围：87-94%）都高于弗里德瓦尔德估值法（范围：71-93%）。用弗里德瓦尔德方法时，约30%的非空腹参与者胆固醇测量值的误差大于10毫克/分升，而新方法与实际测量值只有3%的误差。研究人员报道，计算LDL的整体准确度随甘油三酯水平的升高而下降，尤其是当使用弗里德瓦尔德方法时。例如，6,168名甘油三酯水平在200到399毫克/分升之间的非空腹参与者中，用新方法计算LDL小于70毫克/分升者的准确度是82%，而用弗里德瓦尔德方法的准确度是37%。
该研究的论文发表于2018年1月2日的《循环》(Circulation)杂志。论文资深作者、医学助理教授Seth Shay Martin大夫说：“虽然计算LDL的新方法有点复杂，但妙处在于可以用已包含在血样中的信息执行该方法，求得标准的脂质特征谱，并可在实验室计算机系统内自动执行，给出更准确的结果。因为非空腹样本现在变得准确，病人可以随时来做检查，就算已吃过也无需再重新约，所以对病人来说更加方便。”
Related Links:
约翰霍普金斯大学医学院
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