Apolipoprotein B100 is a better treatment target than calculated LDL and non-HDL cholesterol in statin-treated patients

Autor: Handrean Soran, Michael W France, See Kwok, Sanjaya Dissanayake, Valentine Charlton-Menys, Nahla N Younis, Paul N Durrington
Rok vydání: 2011
Předmět:
Simvastatin
Apolipoprotein B
Atorvastatin
Clinical Biochemistry
chemistry.chemical_compound
Reference Values
Rosuvastatin Calcium
Pravastatin
Aged
80 and over
Clinical Trials as Topic
Sulfonamides
biology
General Medicine
Middle Aged
Apolipoprotein B-100
Regression Analysis
lipids (amino acids
peptides
and proteins)
Analysis of variance
medicine.drug
Adult
medicine.medical_specialty
Statin
Adolescent
medicine.drug_class
Hyperlipidemias
Young Adult
Internal medicine
medicine
Humans
Pyrroles
Triglycerides
Aged
Analysis of Variance
Triglyceride
business.industry
Cholesterol
Cholesterol
HDL
nutritional and metabolic diseases
Cholesterol
LDL
Fluorobenzenes
Pyrimidines
Endocrinology
chemistry
Heptanoic Acids
Non hdl cholesterol
biology.protein
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Zdroj: Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 48:566-571
ISSN: 1758-1001
0004-5632
Popis: Introduction Clinical trials have shown that apolipoprotein B100 (apoB) is better than calculated low-density lipoprotein cholesterol (c-LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C) as a target for statin treatment. However, there are no published reports of how well these targets are reached in patients with more severe hyperlipidaemias than represented in trials, as seen in lipid clinics. Methods We audited 195 patients attending a tertiary centre lipid clinic, who had been treated with a statin for more than one year. We measured total cholesterol, HDL-cholesterol (HDL-C) and triglyceride and from these calculated LDL-cholesterol (LDL-C) and non-HDL-C. We determined the average measured apoB values, at critical target values of LDL-C and non-HDL-C, by linear regression and compared them with values of apoB considered equivalent to these cholesterol indexes by expert groups. We also assessed the number of patients, both before and after treatment, in whom c-LDL-C and non-HDL-C could not be calculated due to hypertriglyceridaemia. Results At the LDL-C target of 2.6 mmol L−1 and the non-HDL-C target of 3.4 mmol L−1, the measured apoB values were significantly higher than consensus apoB target values. The difference was most marked for c-LDL-C in hypertriglyceridaemic subjects and for non-HDL-C in patients without hypertriglyceridaemia. A similar pattern was seen using centile-derived consensus values but the differences were accentuated because this approach generates lower equivalent consensus apoB values. Conclusion ApoB offers a more consistent treatment target independent of hypertriglyceridaemia and would obviate technical problems related to high triglycerides.
Databáze: OpenAIRE
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