Document Detail


Lipid re-screening: what is the best measure and interval?
MedLine Citation:
PMID:  19528038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Osamu Takahashi; Paul P Glasziou; Rafael Perera; Takuro Shimbo; Jiro Suwa; Sonoe Hiramatsu; Tsuguya Fukui
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-14
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-19     Completed Date:  2010-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  448-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Primary Health Care, University of Oxford, Old Road Campus, Roosevelt Drive, Headington, Oxford, OX3 7LF, UK. otakahas@luke.or.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biological Markers / blood
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Coronary Disease / blood,  etiology
Female
Humans
Hyperlipidemias / blood,  complications,  diagnosis*
Japan
Lipids / blood*
Male
Mass Screening / methods*
Middle Aged
Retrospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Lipids
Comments/Corrections
Comment In:
Heart. 2010 Mar;96(6):413-4   [PMID:  20299412 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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