Lipid re-screening: what is the best measure and interval?
| Autor: | Sonoe Hiramatsu, Rafael Perera, Osamu Takahashi, Takuro Shimbo, Paul Glasziou, Tsuguya Fukui, Jiro Suwa |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Coefficient of variation Coronary Disease Hyperlipidemias Teaching hospital Young Adult chemistry.chemical_compound High-density lipoprotein Japan Internal medicine Humans Mass Screening Medicine Aged Retrospective Studies Aged 80 and over business.industry Cholesterol Cholesterol HDL Mean age Cholesterol LDL Middle Aged Lipids Endocrinology chemistry Low-density lipoprotein Female lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine business Body mass index Biomarkers Lipoprotein |
| Zdroj: | Heart. 96:448-452 |
| ISSN: | 1355-6037 |
| Popis: | Objectives To estimate the long-term true change variation (‘signal’) and short-term within-person variation (‘noise’) of the different lipid measures and evaluate the best measure and the optimal interval for lipid re-screening. Design Retrospective cohort study from 2005 to 2008. Setting A medical health check-up programme at a centre for preventive medicine in a teaching hospital in Tokyo, Japan. Participants 15 810 apparently healthy Japanese adults not taking cholesterol-lowering drugs at baseline, with a mean body mass index of 22.5 kg/m 2 (SD 3.2). Main outcome measures Annual measurement of the serum total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and calculation of the ratio of TC/HDL and LDL/HDL. Measurement of the ratio of long-term true change variation (‘signal’) to the short-term within-person variation (‘noise’) for each measure. Results At baseline, participants (53% male) with a mean age of 49 years (range 21–92) and a mean TC level of 5.3 mmol/l (SD 0.9 mmol/l) had annual check-ups over 4 years. Short-term within-person variations of TC, LDL, HDL, TC/HDL, and LDL/HDL were 0.12 (coefficient of variation (CV) 6.4%), 0.08 (CV 9.4%), 0.02 (CV 8.0%) mmol 2 /l 2 , 0.08 (CV 7.9%) and 0.05 (CV 10.6%), respectively. The ratio of signal-to-noise at 3 years was largest for TC/HDL (1.6), followed by LDL/HDL (1.5), LDL (0.99), TC (0.8) and HDL (0.7), suggesting that cholesterol ratios are more sensitive re-screening measures. Conclusion The signal-to-noise ratios of standard single lipid measures (TC, LDL and HDL) are weak over 3 years and decisions based on these measures are potentially misleading. The ratios, TC/HDL and LDL/HDL, seem to be better measures for monitoring assessments. The lipid re-screening interval should be >3 years for those not taking cholesterol-lowering drugs. |
| Databáze: | OpenAIRE |
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