Comparison of Two Point-of-Care Lipid Analyzers for Use in Global Cardiovascular Risk Assessments

2008 ◽  
Vol 42 (5) ◽  
pp. 633-639 ◽  
Author(s):  
Rita A Dale ◽  
Lisa H Jensen ◽  
Mori J Krantz
Keyword(s):  
Small Sample Size ◽  
Point Of Care ◽  
Low Density Lipoprotein ◽  
Venous Blood ◽  
Intraclass Correlation ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Small Sample ◽  
Lipoprotein Cholesterol ◽  
Staff Members

Background: Point-of-care (POC) lipid testing is increasingly used in community-and office-based practice. Two analyzers commonly used in the US are CardioChek PA and Cholostech LDX. Both directly measure total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C), mandatory values in calculating a Framingham Risk Score (FRS). The FRS in turn informs the clinician of the need for lipid-modifying therapy and the degree of therapeutic intensity. Objective: To compare the performance of CardioChek PA and Cholestech LDX. Methods: Staff members from the Colorado Prevention Center were included in the study, with all having fasted for 12 hours beforo the testing. No medical history was obtained. A venous blood sample was collected for lipid measurements conducted in a laboratory, and 2 finger sticks were obtained at that time and analyzed immediately on-site using the POC analyzers. Intraclass correlation coefficients (ICCs) were determined for each analyzer versus the laboratory analysis, with values greater than 0.75 defined as Indicators of excellent reproducibility. We then assessed how interanalyzer differences in TC or HDL-C impacted the FRS lipid categorization. Results: Thirty-four adults (aged 24-56 y) participated in the study. The ICC between Cholestech LDX and the laboratory standard exceeded 075 for all 4 lipid categories (TC, p = 0.96; HDL-C, p = 0.88; low-density lipoprotein cholesterol, ρ = 0.87; triglycerides, ρ = 0.99). By contrast, the only ICC exceeding 0.75 using CardioChek PA was for triglycerides (ρ = 0.84). When applied in calculating the FRS, the Cholestech LDX analyzer misclassified fewer individuals for TC versus the CardioChek PA analyzer (5 vs 21). Overall, Cholestech LDX provided TC and HDL-C values in the correct FRS category more frequently versus CardioChek PA (TC, p < 0.001; HDL-C, p > 0.001). Limitations of the study include use of only 2 POC products and small sample size with no known risk factors. This project does not prove superior accuracy of either device, but reflects a real-world comparison of the analyzers conducted at a single center. Conclusions: The Cholestech LDX analyzer demonstrated better reproducibility than the CardioChek PA analyzer when compared with laboratory gold standard analysis and allowed more accurate categorization for FRS. Since results obtained from these analyzers have the potential to impact treatment decisions, larger, prospective, comparative studies seem warranted.

Comparing the Accuracy of 2 Point-of-Care Lipid Testing Devices

2016 ◽  
Vol 30 (5) ◽  
pp. 490-497 ◽  
Author(s):  
Karen Bastianelli ◽  
Stacey Ledin ◽  
Jennifer Chen
Keyword(s):  
Point Of Care ◽  
Venous Blood ◽  
Intraclass Correlation ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Hdl Cholesterol ◽  
Reference Laboratory ◽  
Average Difference ◽  
Industry Standards ◽  
Finger Stick

Background: Device manufacturers have improved technology since studies were last published, thus warranting an updated analysis. Objective: Two point-of-care (POC) cholesterol testing devices were directly compared to a venous sample to determine device accuracy. Methods: Institutional review board (IRB)–approved study collected finger-stick blood samples analyzed by Cholestech LDX (Cholestech Corporation, Hayward, California) and CardioChek Plus (Polymer Technology Systems Inc, Indianapolis, Indiana) devices and compared to venous blood for 30 study participants. Statistical analyses were completed using StatisPro. Intraclass correlation coefficients were generated, and the average difference expected to be within the industry standards of total cholesterol (TC; ±10%), high-density lipoprotein (HDL) cholesterol (±12%), and triglycerides (TG; ±15%). Results: The POC devices produced clinically equivalent values when compared to the same patients’ samples analyzed in a reference laboratory. The average difference calculated from the actual individual paired percentage bias with the Integra analyzer: venous—TC −3.8%, HDL −6.9%, TG −1.8%; CardioChek—TC −7.8%, HDL −6.2%, TG 5.1%; and Cholestech—TC 0.5%, HDL −4.5%, TG −3.3%. The average of the actual paired percentage bias with the Roche Cobas analyzer: CardioChek—TC −4.2%, HDL 0.8%, TG 7.0% and Cholestech—TC 4.6%, HDL 2.6%, TG −1.6%. Conclusion: Both screening devices operated within industry accuracy standards.

Non–High-Density Lipoprotein Cholesterol and Guidelines for Cholesterol Lowering in Recent History

2019 ◽  
Vol 51 (1) ◽  
pp. 14-23
Author(s):  
Stanley S Levinson
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Low Density Lipoprotein Cholesterol ◽  
Staff Members ◽  
Recommended Treatment ◽  
Target Values ◽  
Biochemical Mechanisms ◽  
High Density Cholesterol

Abstract Background The National Cholesterol Education Program (NCEP) released guidelines for treating cholesterol in 1988, 1994, and 2002. After a hiatus, the guidelines were released again in 2013, 2016, 2017, and 2018. Methods In this article, I review these guidelines, factors that affected their release, how they evolved, and why recommended treatment targets are reasonable. Also, to aid reader understanding, I briefly discuss biochemical mechanisms and the pathophysiology of beta-lipoproteins, focusing on the importance on non–high-density cholesterol (non-HDLC) in assessing risk and as a target for treatment. The concepts discussed are important to laboratory clinicians because those workers inscribe target values on the reports and may consult with medical staff members. Conclusions The newest recommendations, released in 2018, are an extension of the 2017 guidelines that defined non-HDLC as equivalent to low-density lipoprotein cholesterol (LDLC). For the reasons discussed herein, non-HDLC has advantages over LDLC. Laboratories reporting cholesterol results should include non-HDLC values and cutoffs in their reports.

scholarly journals Comparison Between Fasting and Non-Fasting Cut-Off Values of Triglyceride in Diagnosing High Triglyceride in Chinese Hypertensive Outpatients

2021 ◽  
Author(s):  
Yingying Xie ◽  
Peiliu Qu ◽  
Tie Wen ◽  
Ling Liu ◽  
Xiao Du ◽  
...  
Keyword(s):  
Blood Lipids ◽  
Statistical Significance ◽  
Low Density Lipoprotein ◽  
Venous Blood ◽  
Density Lipoprotein ◽  
Direct Methods ◽  
Blood Lipid ◽  
Serum Levels ◽  
Lipoprotein Cholesterol ◽  
Fasting State

Abstract Background: Hypertension (HBP) often occurs together with hypertriglyceridemia that indicates elevated triglyceride (TG) and remnant cholesterol (RC) levels. Non-fasting (i.e. postprandial) blood lipid test after a daily meal has been recommended by the European Atherosclerosis Society (EAS). However, little is known about the difference between fasting and non-fasting cut-off values in assessing high TG (HTG) and high RC (HRC) in HBP outpatients.Methods: Two hundred and twenty-five Chinese outpatients with HBP were enrolled in this study. According to the time of blood lipid test, they were divided into two groups, i.e. the fasting group (n=119) and the non-fasting group (n=139). Non-fasting levels of blood lipids at 2 h after a daily breakfast were also tested in 33 patients among the fasting group. Venous blood samples were collected. Serum levels of blood lipids were measured by the enzymatic and direct methods on a HITACHI 7170A analyzer or estimated via related formulas. Results: The non-fasting group had significantly higher levels of TG and RC while lower levels of total cholesterol, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol than the fasting group (P＜0.05). According to TG and RC cut-off values of the EAS, the percentages of HTG and HRC in the non-fasting group were 67.6% and 65.6%, respectively, while those in the fasting group were 57.1% and 52.9%, respectively. However, the percentages of HTG in the fasting state and at 2 h after a daily breakfast in 33 outpatients did not reach statistical significance (57.6% v.s. 51.5%). So did the fasting and at 2 h non-fasting percentages of HRC in them.Conclusion: Non-fasting blood lipid test could find more HBP outpatients with HTG in Chinese outpatients with HBP. However, the percentage of HTG at 2h after a daily breakfast seemed to be close to that in the fasting state.

scholarly journals Associations between lipid profiles of adolescents and their mothers based on a nationwide health and nutrition survey in South Korea

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024731 ◽  
Author(s):  
Ji Hyung Nam ◽  
Jaeyong Shin ◽  
Sung-In Jang ◽  
Ji Hyun Kim ◽  
Kyu-Tae Han ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Lipid Profiles ◽  
Lipoprotein Cholesterol ◽  
Lipid Levels ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Unit Increase

ObjectivesDyslipidaemia is a metabolic disease influenced by environmental and genetic factors. Especially, family history related to genetic background is a strong risk factor of lipid abnormality. The aim of this study is to evaluate the association between the lipid profiles of adolescents and their mothers.DesignA cross-sectional study.SettingThe data were derived from the Korea National Health and Nutrition Examination Survey (IV-VI) between 2009 and 2015.Participants2884 adolescents aged 12–18 years and their mothers were included.Primary outcome measuresOutcome variables were adolescents’ lipid levels. Mothers’ lipid levels were the interesting variables. The lipid profiles included total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). We identified partial correlation coefficients (r) between the lipids. Multiple linear regressions were performed to identify the amount of change in adolescents’ lipid levels for each unit increase of their mothers’ lipids. The regression models included various clinical characteristics and health behavioural factors of both adolescents and mothers.ResultsThe mean levels of adolescents’ lipids were 156.6, 83.6, 50.4 and 89.4 mg/dL, respectively for TC, TG, HDL-C and LDL-C. Positive correlations between lipid levels of adolescents and mothers were observed for TC, TG, HDL-C and LDL-C (r,95% CI: 0.271, 0.236 to 0.304; 0.204, 0.169 to 0.239; 0.289, 0.255 to 0.322; and 0.286, 0.252 to 0.319). The adolescent TC level was increased by 0.23 mg/dL for each unit increase of the mother’s TC (SE, 0.02; p<0.001). The beta coefficients were 0.16 (SE, 0.01), 0.24 (SE, 0.02) and 0.24 (SE, 0.02), respectively, in each model of TG, HDL-C and LDL-C (all p<0.001). The linear relationships were significant regardless of sex and mother’s characteristics.ConclusionsMothers’ lipid levels are associated with adolescents’ lipids; therefore, they can serve as a reference for the screening of adolescent’s dyslipidaemia.

Abstract P113: Lipid-related Genetic Variants and Lipid Outcomes in a Cohort of Chilean Children

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Ann Von Holle ◽  
Anne Justice ◽  
Kari E North ◽  
Bárbara Angel ◽  
Estela Blanco ◽  
...  
Keyword(s):  
Genetic Variants ◽  
Genetic Model ◽  
Small Sample Size ◽  
A Priori ◽  
Density Lipoprotein ◽  
The United States ◽  
Small Sample ◽  
Lipoprotein Cholesterol ◽  
Risk Scores ◽  
Lipid Levels

Dyslipidemia is an important risk factor for chronic cardiometabolic diseases. Lipid traits are highly heritable and there are currently >185 established loci influencing lipid levels in adults. Recent studies have confirmed that variants associated with lipids influence lipid levels across the lifecourse, and in ancestrally diverse populations. Given that Hispanic/Latinos (HL) shoulder much of the cardiometabolic burden in the United States, it is important to identify genetic variants that contribute the greatest risk for elevated lipid levels across life stages. Thus, our primary aim is to examine the association of known lipid variants with lipid traits identified in large study of adult participants from a Chilean infancy cohort of primarily European-descent. The sample assessed from 2008 to 2013 (n=546) had genotyping and well-measured lipid phenotypes (median age: 16.8 years, interquartile range: 16.6, 16.9). We assessed single variant associations using linear regression for high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG), assuming an additive genetic model, adjusted for sex. Additionally, we regressed phenotypes onto weighted trait-specific polygenic risk scores (PRS). Only six variants from the Chilean sample met the a priori threshold of power > 0.8. We found statistically significant effect sizes (mmol/l (se)) for four of the six variants: rs3764261 (0.16 (0.04)) and rs1532085 (0.05 (0.04)) for HDL and rs1260326 (0.34 (0.15)) and rs964184 (0.33 (0.15)) for TG. For each significant variant, direction of effect matched the multiethnic adult GWAS from which SNPs were selected. We compared our findings to a previous study in Finnish children at age 18 years (n=1,216) and found an opposite direction of effect for our significant HDL variants. Likewise, when comparing coefficients for the PRS between the Chilean and Finnish youth sample we found the association to be stronger in the Chilean sample for every trait and gender group with the exception of LDL for males. The lipid loci explained the least amount of total variance for LDL (males=4% and females=5%) and the most amount of variance for HDL (males=20% and females=14%). In conclusion, there is evidence that lipid loci from a HL sample of adolescents contain similar associations as those from European children and adults. Despite the small sample size and possibility for bias with different ancestral groups we found meaningful and statistically significant associations relating lipid loci in a HL cohort of Chilean adolescents with those found in European ancestral groups. These associations emphasize the importance of adolescence as a time for disease prevention given studies demonstrating both the persistence of associations between PRS and lipids over the life course and the increasing role PRS plays in predicting disease.

scholarly journals Validation of multiple equations for estimating low-density lipoprotein cholesterol levels in Korean adults

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Rihwa Choi ◽  
Mi-Jung Park ◽  
Youngju Oh ◽  
Sung Ho Kim ◽  
Sang Gon Lee ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Intraclass Correlation ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Korean Population ◽  
Percentage Error ◽  
Laboratory Population ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
New Equation

Abstract Background Limited data are available for validation of low-density lipoprotein cholesterol (LDL) calculation (LDLcal) in the adult Korean population. The aim of this study was to develop and validate a new equation for LDLcal and to compare it with previous such equations in a Korean population. Methods A new equation for LDLcal was developed (LDLChoi). LDLChoi and 11 other previously published equations were applied and compared with directly measured LDL concentration (LDLdirect) in a development cohort (population 1), an independent validation cohort in the same laboratory (population 2), and the Korea National Health and Nutrition Examination Survey 2017 cohort (population 3). Results Among the 12 equations, the newly-developed equation (LDLChoi = total cholesterol – 0.87 x high-density lipoprotein cholesterol – 0.13 x triglycerides) had the highest intraclass correlation coefficient (ICC) and the lowest mean systemic difference and median absolute percentage error in populations 1 and 2 but not in population 3. Subgroup analysis showed good agreement between LDLChoi and LDLdirect (ICC > 0.75) in population 2, whose LDLdirect < 70 mg/dL. For samples with high triglycerides (> 400 mg/dL), equation accuracy varied. Categorization concordance according to the National Cholesterol Education Program Adult Treatment Panel III criteria with the other 11 equations were less than 80%; that of LDLChoi was 87.6 and 87.4% in populations 1 and 2, respectively. Conclusions Accuracy of 12 equations for LDLcal varied by cohort and subgroup based on LDLdirect and triglycerides. A laboratory-specific equation for LDLcal and/or LDLdirect may be needed for accurate evaluation of LDL status.

scholarly journals Randomized Control Trial Study On The Effect Of Wet Cupping On Lipid Profile

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Suhaily MH ◽  
Ismail AA ◽  
Najib MY
Keyword(s):  
Lipid Profile ◽  
Serum Lipid ◽  
Controlled Trial ◽  
Low Density Lipoprotein ◽  
Venous Blood ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Control Group ◽  
The Third

Introduction: Dyslipidaemia is one of the risk factors contributing to the pathogenesis of cardiovascular   diseases (CVDs). This study was conducted to investigate the effect of wet cupping on lipid profile. Methods: This randomized controlled trial was conducted in 2012 at the School of Medical Sciences, Universiti Sains Malaysia, Malaysia. Sixty-two healthy volunteers ranging from 30 to 60 years old were randomized into control and intervention groups. Subjects in the intervention group were assigned to two sessions of wet cupping at the beginning of the study and at the third month; individuals in the control group did not undergo any cupping procedure. Venous blood sample was collected for serum lipid profile: Total Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C), and triglycerides; measured at baseline, first, third and fourth month. Results: Subjects in the cupping group had significant improvements from baseline to third and fourth month for TC (MD=-0.56, P=0.004), HDL-C (MD=-0.22, P<0.001) and LDL-C (MD=0.58, P=0.001). There was also a significant reduction from baseline to one month for triglycerides (MD=0.38, P<0.001). Subjects in the cupping group had significantly better values in HDL-C and LDL-C as compared with the control group at the third and fourth month. Significantly lower levels of TC and triglycerides in the cupping group of the fourth month. In the control group, there were no significant changes in any serum lipid profiles. Conclusion: After two sessions of wet cupping, TC, HDL-C, LDL-C and triglycerides were significantly improved by 8.2%, 13.7%, 16.4% and 20.8% respectively.

scholarly journals Comparative Assessment of LDL-C and VLDL-C Estimation in Familial Combined Hyperlipidemia using Sampson’s, Martin’s and Friedewald’s Equations.

2021 ◽  
Author(s):  
Arsenio Vargas-Vázquez ◽  
Omar Bello-Chavolla ◽  
Neftali Eduardo Antonio-Villa ◽  
Roopa Mehta ◽  
Ivette Cruz-Bautista ◽  
...  
Keyword(s):  
Mean Squared Error ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Familial Combined Hyperlipidemia ◽  
Mixed Dyslipidemia ◽  
Lipoprotein Composition

Abstract Background: Sampson et al developed a novel method to estimate very low-density lipoprotein cholesterol (VLDL-C) and low-density lipoprotein cholesterol (LDL-C) in the setting of hypertriglyceridemia. Familial Combined Hyperlipidemia (FCHL) is a common primary dyslipidemia in which lipoprotein composition interferes with LDL-C estimation. This study aimed to evaluate performance of LDL-C using this new method (LDL-S) compared with LDL-C estimated by Friedewald’s and Martin equation (LDL-F, LDL-M) in FCHL.Methods: Data were collected from 340 subjects with confirmed FCHL. Concordance for VLDL-C measured by ultracentrifugation and LDL-C estimated using these measures compared to Sampson’s, Martin’s and Friedewald’s equations was performed using correlation coefficients, root mean squared error (RMSE) and bias. We also assessed concordance of misclassified metrics according to LDL-C (<70 and <100mg/dL) and ApoB (<80 and <65mg/dL) thresholds.Results: Sampson’s equation was more accurate (RMSE 11.21 mg/dL; R2=0.88) compared to Martin’s (RMSE 13.15 mg/dL; R2=0.875) and the Friedewald equation (RMSE 13.7 mg/dL; R2= 0.869). When assessing performance according to LDL-C, Sampson’s had highest correlation and lowest RMSE compared to other equations (RMSE 19.99 mg/dL; R2=0.840). Comparing performance strength across triglyceride levels, Sampson’s showed consistently improved correlations compared to Martin’s and Friedewald’s formulas for increasing triglycerides and for the FCHL phenotype of mixed dyslipidemia. Sampson’s also had improved concordance with treatment goals.Conclusions: In FCHL, VLDL-C and LDL-C estimation using Sampson’s formula showed higher concordance with lipid targets assessed using VLDL-C obtained by ultracentrifugation compared with Friedewald’s and Martin’s equations. Implementation of Sampson’s formula could improve treatment monitoring in FCHL.

Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge

1972 ◽  
Vol 18 (6) ◽  
pp. 499-502 ◽  
Author(s):  
William T Friedewald ◽  
Robert I Levy ◽  
Donald S Fredrickson
Keyword(s):  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Cholesterol Content ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Plasma Total Cholesterol

Abstract A method for estimating the cholesterol content of the serum low-density lipoprotein fraction (Sf0-20) is presented. The method involves measurements of fasting plasma total cholesterol, triglyceride, and high-density lipoprotein cholesterol concentrations, none of which requires the use of the preparative ultracentrifuge. Comparison of this suggested procedure with the more direct procedure, in which the ultracentrifuge is used, yielded correlation coefficients of .94 to .99, depending on the patient population compared.

scholarly journals Effect of Carrageenans on Vegetable Jelly in Humans with Hypercholesterolemia

Marine Drugs ◽  
2019 ◽  
Vol 18 (1) ◽  
pp. 19 ◽  
Author(s):  
Ana Valado ◽  
Maria Pereira ◽  
Armando Caseiro ◽  
João P. Figueiredo ◽  
Helena Loureiro ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Low Density Lipoprotein ◽  
Venous Blood ◽  
Daily Intake ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density Lipoprotein Cholesterol ◽  
Main Risk Factor ◽  
Commercial Kits ◽  
Bioactive Potential

Changes in lipid profile constitute the main risk factor for cardiovascular diseases. Algae extracted carrageenans are long-chain polysaccharides and their ability to form gels provides for the formation of vegetable jelly. The objective was to evaluate the bioactive potential of carrageenan (E407) in the lipid profile, after ingestion of jelly. A total of 30 volunteers of both sexes, aged 20–64 years and with total cholesterol (TC) values ≥200 mg/dL, who ingested 100 mL/day of jelly for 60 days, were studied. All had two venous blood collections: before starting the jelly intake and after 60 days. At both times, TC, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG), were evaluated using commercial kits and spectrophotometer. The statistics were performed using the SPSS 25.0 software and p < 0.05 were considered statistically significant. Serum values after 60 days of jelly intake revealed a statistically significant decrease in TC levels (5.3%; p = 0.001) and LDL-C concentration (5.4%; p = 0.048) in females. The daily intake of vegetable jelly for 60 days showed a reduction in serum TC and LDL-C levels in women, allowing us to conclude that carrageenan has bioactive potential in reducing TC concentration.

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