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Objective:The results of the three lipid detection systems were compared to analyze their influence on risk stratification and clinical treatment in lipid management, especially the target goal cut-off point determination, and to find ways to reduce the impact on target goal determination of various lipid measurement system.Methods:A total of 196 serum samples with triglyceride TG <4.5 mmol/L were collected from people undergoing physical examinations and in-patients in the Second Xiangya Hospital of Central South University from August to October 2022. Triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were directly detected with Hitachi-Woke (HW), Roche and Mindray detection systems, respectively. The non high-density lipoprotein cholesterol (non HDL-C) was calculated by formula (TC-HDL-C) and LDL-C (F-LDL-C) was calculated by Friedewald formula, and results from various methodology were compared. The coefficient of variation ( CV) of these six indicators derived from the three detection systems were calculated to evaluate the consistency of the obtained results from different venders. In addition, the Pearson correlation coefficient was analyzed to evaluate the correlation of each indicator among different systems. According to the Chinese Guidelines for Blood Lipid Management, samples were divided into groups with LDL-C levels of <1.4, 1.4-<1.8, 1.8-<2.6, 2.6-<3.4 and ≥3.4 mmol/L according to the recommended LDL-C levels for different risk stratification levels. The sample size and percentage of LDL-C test results from different systems in the same group were counted to evaluate the impact of LDL-C differences between systems on clinical decision-making of blood lipid management. The correction factor was calculated through two methods: (1) The average deviation of LDL-C between systems was estimated by EP9-A3 method; (2) Multiple linear stepwise regression was used to establish the regression model of LDL-C difference and related indexes between systems. The two correction factors were used to correct the deviation of LDL-C value obtained from various systems, and Chi-square test was used to compare the difference of LDL-C grouping consistency rate before and after correction. Result:The average CV values of TG, TC, LDL-C, F-LDL-C, HDL-C, and non HDL-C among the three detection systems were 4.84%, 1.92%, 11.96%, 3.81%, 5.82% and 2.61%, respectively. Correlation analysis showed that when comparing the three systems in pairs, except for LDL-C derived from HW and Roche′s, and Mindray and Roche′s LDL-C ( R 2=0.938 and 0.947), the R 2 of other indicators were all greater than 0.97. The consistency rates of the three systems on LDL-C and F-LDL-C were 51.0% (100/196) and 90.8% (178/196), respectively, according to the risk stratification standard values and the difference was statistically significant ( P<0.05). When comparing in pairs, the consistency rates of Roche and HW, Mindray and HW, Mindray and Roche system LDL-C grouping were 60.7% (119/196), 82.7% (162/196), and 54.1% (106/196), respectively. After adjusting for mean deviation, the group consistency rate of Roche and HW increased to 73.7%-79.4% ( P<0.05), and the group consistency rate of Roche and Mindray increased to 72.3%-79.0% ( P<0.05). After adjusting for difference regression model, the group consistency rate of Roche and HW increased to 82.5%-84.0%, and the group consistency rate of Roche and Mindray increased to 81.0%-89.2%. However, there was no significant change in the group consistency rate of Mindray and HW after adjusting for both correction methods ( P>0.05) .Conclusions:There are significant differences in LDL-C derived from different detection systems, and the consistency rate of grouping according to the lipid-lowering standard value is relatively low, which may affect clinical decision-making in lipid management. Adjusted by the correction factor, the consistency rate of grouping between Roche and HW, Roche and Mindray systems with large differences in LDL-C can be improved. Using the difference multiple linear regression model as a correction factor is superior to the average deviation.
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New techniques in clinical lipid measurements, such as vertical auto profile, nuclear magnetic resonance spectroscopy, electrospray differential mobility analysis and liquid chromatography-mass spectrometry/mass spectrometry, are becoming increasingly mature. Clinical application of these new techniques significantly promoted the use of new lipid parameters including the particle concentrations of low-density lipoprotein/high-density lipoprotein and other lipoprotein subtype in the risk stratification of atherosclerotic cardiovascular disease and in the efficacy monitoring of lipid-regulating therapy, above progress is helpful on developing new individualized and precise lipid management strategies. This review analyzed and summarized the research progress of the new techniques for lipid measurements in recent years, aiming to provide evidence to develop new ideas for the individualized and accurate lipid management in clinical practice.
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@#AIM: To study the serum lipids changes and lipid ratiosin patients with pterygium. <p>METHODS: Based on the retrospective study, 500 pterygium patients who were admitted to the department of ophthalmology and had finished physical examination in the physical examination center of Zhongnan Hospital of Wuhan University from January 2016 to February 2019 were included. As well as 500 people who underwent health examination and were matched in age and gender at the same time. The serum levels of triglycerides(TG), total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C), were measured by professionals in hospital. TG/HDL, TC/HDL, LDL/HDL were calculated and analyzed statistically between the two groups.<p>RESULTS: Among the 500 patients with pterygium, abnormal serum lipid content accounted for 68.2%(341/500). TG, TC, LDL-C level and TG/HDL, TC/HDL and LDL/HDL were higher in pterygium group than control, and with statistically significant differences(<i>P</i><0.001). While serum HDL level was lower than that in control group and with no statistically significant differences(<i>P</i>>0.05). According to Logistic analysis, TG(<i>OR</i>=4.132), TC(<i>OR</i>=2.194), TG/HDL(<i>OR</i>=2.184)and TC/HDL(<i>OR</i>=2.007)were risk factors for pterygium(<i>P</i><0.05). <p>CONCLUSION: Dyslipidemia is an important factor in the pathogenesis of pterygium. It is very necessary for the patients with pterygium to control the level of blood lipids because it has important clinical significance for the attack and treatment of them.
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Atherosclerosis is the pathological basis of coronary heart disease, ischemic stroke and peripheral vascular disease (atherosclerotic cardiovascular disease, ASCVD). Blood cholesterol levels are closely related to ASCVD. The preva-lence and mortality of cardiovascular disease are increasing in China, which is a difficult task. The lipid management goal is to reduce the risk of ASCVD. Atherogenic cholesterol-non-high-density lipoprotein cholesterol (non-HDL-C) and low-den-sity lipoprotein cholesterol (LDL-C) are used as the primary targets of therapy, which may be more appropriate for lipid man-agement setting dislipidaemia value applied to Chinese clinic. Lifestyle intervention is the basis of lipid management. Effec-tive prevention and treatment of ASCVD require the comprehensive intervention of risk factors.