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 |
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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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