오히려 LDL 콜레스테롤 보다 비 HDL 콜레스테롤을 사용하는 것의 타당성
Validity for Use of Non-HDL Cholesterol Rather than LDL Cholesterol
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NonHDL cholesterol values have been suggested as a risk marker for cardiovascular disease. NonHDL cholesterol values were calculated, using a very simple measurement [nonHDL cholesterol =serum total cholesterol-HDL cholesterol]. This formula is very useful as a screening tool for identifying dyslipoproteinemias, risk assessment, and assessing the results of hypolipidemic therapy. The data from the 2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,992 subjects with lipid panels (Cholesterol, HDL, LDLdirect and Triglycerides) results. We studied the relationship between nonHDL cholesterol and LDL cholesterol. As a result, nonHDL cholesterol values were plotted against the LDL direct and calculated values. The linear regression equation for nonHDL cholesterol and direct LDL cholesterol was nonHDLchol=23.60+1.03×LDLdirect (p<0.0001, r2=0.80) in all subjects. The subjects were classified into triglyceride values. When triglycerides are below 400 mg/dL, the linear fit to LDL direct is found to be [nonHDLchol=17.34+1.07×LDLdirect] (p<0.0001, r2=0.88) and to the Friedewald LDL calculation is [nonHDLchol=23.10+1.02×LDLcalc] (p<0.0001, r2=0.82). For triglycerides above 400 mg/dL, the linear fit equation is [nonHDLchol=87.57+0.92×LDLdirect] (p <0.0001, r2=0.50) and to the LDL calculated, it is [nonHDLchol=142.70+0.50×LDLcalc] (p <0.0001, r2=0.32). This study provides examples of the utility of nonHDL cholesterol concentrations in clinical medicine.
Abstract
NonHDL cholesterol values have been suggested as a risk marker for cardiovascular disease. NonHDL cholesterol values were calculated, using a very simple measurement [nonHDL cholesterol =serum total cholesterol-HDL cholesterol]. This formula is very useful as a screening tool for identifying dyslipoproteinemias, risk assessment, and assessing the results of hypolipidemic therapy. The data from the 2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,992 subjects with lipid panels (Cholesterol, HDL, LDLdirect and Triglycerides) results. We studied the relationship between nonHDL cholesterol and LDL cholesterol. As a result, nonHDL cholesterol values were plotted against the LDL direct and calculated values. The linear regression equation for nonHDL cholesterol and direct LDL cholesterol was nonHDLchol=23.60+1.03×LDLdirect (p<0.0001, r2=0.80) in all subjects. The subjects were classified into triglyceride values. When triglycerides are below 400 mg/dL, the linear fit to LDL direct is found to be [nonHDLchol=17.34+1.07×LDLdirect] (p<0.0001, r2=0.88) and to the Friedewald LDL calculation is [nonHDLchol=23.10+1.02×LDLcalc] (p<0.0001, r2=0.82). For triglycerides above 400 mg/dL, the linear fit equation is [nonHDLchol=87.57+0.92×LDLdirect] (p <0.0001, r2=0.50) and to the LDL calculated, it is [nonHDLchol=142.70+0.50×LDLcalc] (p <0.0001, r2=0.32). This study provides examples of the utility of nonHDL cholesterol concentrations in clinical medicine.
참고문헌 (25)
- Boekholdt SM, "Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis", JAMA, 307, pp.1302~1309 (2012)
- Dinovo EC, "Calculated nonHDL cholesterol - an alternative to LDL?", Clin Chem, 56(6), pp.A182~ (2010)
- Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge", Clin Chem, 18, pp.499~502 (1972)
- Frost PH, "Rationale for use of non–high-density lipoprotein cholesterol rather than low-density lipoprotein cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy", Am J Cardiol, 81(4), pp.26B~31B (1998)
- Hoenig MR, "Implication of the obesity epidemic for lipid-lowering therapy: non–HDL Cholesterol should replace LDL cholesterol asthe primary therapeutic target", Vasc Health Risk Manag, 4, pp.143~156 (2008)
- Jun KR, "Effects of total cholesterol and triglyceride on the percentage difference between the low-density lipoprotein cholesterol concentration measured directly and calculated using the Friedewald formula", Clin Chem Lab Med, 46, pp.371~375 (2008)
- Kamezaki F, "A direct measurement for LDL-cholesterol increases hypercholesterolemia prevalence: comparison with Friedewald calculation", J UOEH, 32, pp.211~220 (2010)
- 권세영, "LDL 콜레스테롤 직접 측정법과 다양한 공식을 사용한 추정의 비교", 대한임상검사과학회지, 44(3), pp.103~111 (2012), 대한임상검사과학회
- Lindsey CC, "A clinical comparison of calculated versus direct measurement of low-density lipoprotein cholesterol level", Pharmacotherapy, 24, pp.167~172 (2004)
- Liu J, "Non-high-density lipoprotein and very-low-density lipoprotein cholesterol and their risk predictive values in coronary heart disease", Am J Cardiol, 98, pp.1363~1368 (2006)
- Miller M, "Relative atherogenicity and predictive value of non-highdensity lipoprotein cholesterol for coronary heart disease", Am J Cardiol, 101, pp.1003~1008 (2008)
- Miller WG, "Performance of four homogenous direct methods for LDLcholesterol", Clin Chem, 48, pp.489~498 (2002)
- National Cholesterol Education Program (NCEP) Expert Panel, "Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)", JAMA, 285, pp.2486~2497 (2001)
- Nauck M, "Methods for measurement of LDL cholesterol: a critical assessment of direct measurement by homogeneous assays versus calculation", Clin Chem, 48, pp.236~254 (2002)
- Ricos C, "Current databases on biological variation: pros, cons and progress", Scand J Clin Lab Invest, 59, pp.491~500 (1999)
- Rossouw JE, "The value of lowering cholesterol after myocardial infarction", N Engl J Med, 323, pp.1112~1119 (1990)
- Schectman G, "Variability in cholesterol measurements: comparison of calculated and direct LDL cholesterol determinations", Clin Chem, 42, pp.732~737 (1996)
- Sigdel M, "Non-high density lipoprotein cholesterol versus low density lipoprotein cholesterol as a discriminating factor for myocardial infarction", BMC Research Notes, 5, pp.640~ (2012)
- Stamler J, "Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT)", JAMA, 256, pp.2823~2828 (1986)
- Teerakanchana T, "Comparative study of LDL-cholesterol levels in Thai patients by the direct method and using the Friedewald formulas", Southeast Asian J Trop Med Publ Health, 38, pp.519~527 (2007)
- Trembley AJ, "Validation of the Friedewald formula for the determination of low-density lipoprotein cholesterol compared with β-quantification in a large population", Clin Biochem, 37, pp.785~790 (2004)
- Vaccaro JA, "Relationship of lifestyle medical advice and non–HDL Cholesterol control of a nationally representative US sample with hypercholesterolemia by race", ethnicity, 2012, 1~7
- van Deventer HE, "Direct LDL-C methods do not significantly improve cardiovascular risk classification over calculated LDL-C or non-HDL-C when compared to the reference measurement procedure", Clin Chem, 56(6), pp.A186~ (2010)
- van Deventer HE, "Non–HDL cholesterol shows improved accuracy for cardiovascular risk score classification compared to direct or calculated LDL- cholesterol in a dyslipidemic population", Clin Chem, 57, pp.490~501 (2011)
- Wilson PWF, "Prediction of coronary heart disease using risk factor categories", Circulation, 97, pp.1837~1847 (1998)
