BACKGROUND:High-density lipoprotein cholesterol (HDL-C) is important in risk assessment for cardiovascular disease or metabolic syndrome; however, different direct HDL-C assays may lead to erroneous risk estimates and potentially misclassify people. METHODS:Data for 30-year HDL-C trends in Finland were obtained from the national FINRISK surveys during 1982-2012 (n=45766) taking into account biases from three external quality assessment programs (EQA). We also compared two different direct HDL-C and turbidimetric apolipoprotein A-I methods using 413 fresh serum samples. RESULTS:HDL-C concentrations in the Finnish population were on average 1.33 (±0.04) mmol/l for men and 1.62 (±0.05) mmol/l for women after bias-correction. Positive HDL-C trends were observed for both sexes with original data, but trends disappeared after bias-correction. Comparison of two direct HDL-C methods demonstrated concentration-dependent difference. When HDL-C concentrations were <1.0 mmol/l, the mean bias was -12.0% (95% CI -13.5 to -10.0) whereas HDL-C concentrations >1.55 mmol/l showed mean bias of 9.0% (95% CI 7.0-10.5). CONCLUSIONS:Accurate reporting of HDL-C concentrations at the population level requires proper and regular attendance to reliable EQA programs. We found evidence for a concentration-dependent difference between some direct HDL-C methods, which may cause misclassification of people in cardiovascular risk assessment.

译文

背景:高密度脂蛋白胆固醇(HDL-C)在心血管疾病或代谢综合征的风险评估中很重要。但是,不同的直接HDL-C分析可能会导致错误的风险估计并可能对人员进行错误分类。
方法:芬兰30年HDL-C趋势的数据是从1982年至2012年的全国FINRISK调查中获得的(n = 45766),其中考虑了三个外部质量评估计划(EQA)的偏差。我们还比较了使用413种新鲜血清样本的两种不同的直接HDL-C和浊度载脂蛋白A-I方法。
结果:校正偏倚后,芬兰人群中HDL-C的平均浓度为男性1.33(±0.04)mmol / l,女性为1.62(±0.05)mmol / l。具有原始数据的两性均观察到HDL-C呈阳性趋势,但偏差校正后该趋势消失。两种直接HDL-C方法的比较显示出浓度依赖性差异。当HDL-C浓度<1.0 mmol / l时,平均偏差为-12.0%(95%CI -13.5至-10.0),而HDL-C浓度> 1.55 mmol / l则显示平均偏差为9.0%(95%CI 7.0) -10.5)。
结论:要在人群中准确报告HDL-C浓度,需要适当定期参加可靠的EQA计划。我们发现一些直接HDL-C方法之间存在浓度依赖性差异的证据,这可能会导致心血管风险评估中人员分类错误。

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