Biological Variation of Serum Lipids and lipoproteins in Patients with Clinically Well Controlled Non Insulin Dependent Diabetes Mellitus

Endocrine Journal

Türker KUTLUAY²  M. ALI GÜNDOGAN¹  N. KEMAL NAZAROGLU²  CUMHUR BIL GI²  METIN ÖZATA¹  LEVENT KARACA²  METIN YILDIRIMKAYA² 

[1] Departments of Endocrinology and Metabolism, Gülhane School of Medicine;Departments of Biochemistry, Gülhane School of Medicine

关键词: Intra-individual variation;    Diabetes mellitus;    Cholesterol;    Triglyceride;    Lipoproteins;   

DOI  :  10.1507/endocrj.43.345

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(22)Cited-By(2)To investigate how the visit-to-visit variation in serum lipids measurements affects the decision making concerning treatment according to the National Cholesterol Education Program (NCEP) guidelines in patients with clinically well controlled non-insulin-dependent diabetes mellitus (NIDDM) we have measured the biological variation (CVb) in serum total cholesterol (IC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in 26 patients with NIDDM. We found the CVb as follows: TC, 5.1%; TG, 17.0%; HDL-C 4.4% and LDL-C, 8.3%. Confidence intervals (95%) were determined with total intra-individual variance values around the NCEP cut-off points to evaluate how well one, two and three lipid measurements provided reliable risk classification. A single TC measurements <177mg/dL or >263mg/dL allowed confident classification as “desirable” or “high risk” respectively. For LDL-C, one measurement was accurate only at below 106.3mg/dL or above 183.7mg/dL. The average of three measurements contracted these limits to <186.7mg/dL and >253.3mg/dL for TC, and <116.3mg/dL and >173.7 mg/dL for LDL-C. For HDL-C also, multiple measurements improved risk assignment in a similar fashion. There were no values which allowed assignment to the “borderline high” category with one TC measurement and with one and two LDL-C measurements. The mean of three TC and three LDL-C measurements allowed assignment to the “borderline high” category, if between 213.3 and 226.7mg/dL for TC, 143.7 and 146.3 mg/dL for LDL-C. Seven patients (26.9%) in this risk group based on the mean of two LDL-C estimates could be placed into a different category when the mean of three estimates was taken, even though the first two LDL-C test results did not differ by more than 30mg/dL. Our results suggest that repeated lipid measurement is important especially for the “borderline-high” risk group because big variations existed in some patients, and further that TC is the most reliable quantity.

【 授权许可】

Unknown