Can measurement of serum apolipoprotein B replace the lipid profile monitoring of patients with lipoprotein disorders?
| Autor: | Miremadi S; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6Z 1Y6, Canada., Sniderman A, Frohlich J |
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| Jazyk: | angličtina |
| Zdroj: | Clinical chemistry [Clin Chem] 2002 Mar; Vol. 48 (3), pp. 484-8. |
| Abstrakt: | Background: Current clinical guidelines require that five indices (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and the total/HDL cholesterol ratio) be measured or calculated to assess the lipid-related risk of vascular disease. All five are also targets of therapy and therefore all must be measured initially and at follow-up. Considerable evidence indicates that apolipoprotein B (apo B) is a better index of reaching or not reaching treatment targets than total or LDL cholesterol. Methods: The objective of this study was to examine whether measurement of a single marker (apo B) led to the same categorization of risk as the traditional five indices (lipid profile). If both apo B and lipid profile indicated that the patient was either within or outside their respective treatment targets, the indices were considered concordant. If not, the indices were considered discordant. Concordance/discordance was examined in 215 patients at their first and last clinic visit. Results: Concordance was high in both higher (88% at the first and 92% at the last clinic visit) and lower (76% at the first and 78% at the last clinic visit) risk groups at both the initial and final visits. Discordance was virtually restricted to the group with hypertriglyceridemia with normal concentrations of apo B, a group in which little independent evidence points to any substantially increased risk of vascular disease. Conclusions: These data raise the possibility that at least for high risk patients treated with statins, follow-up could be simplified and expenses reduced if only apo B were measured. They also raise the possibility that outcome might be improved if the therapeutic algorithm were simplified. |
| Databáze: | MEDLINE |
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