Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercholesterolemia
Although total cholesterol concentrations measured by portable lipid analyzers have acceptable bias and precision in young and middle-aged adults, clinically relevant differences in HDL-cholesterol (HDL-C) and triglyceride values have been described. Furthermore, the accuracy of portable lipid analy...
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| Veröffentlicht in: | Clinical chemistry (Baltimore, Md.) Md.), 2002-02, Vol.48 (2), p.284-290 |
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| creator | STEIN, James H CARLSSON, Cynthia M PAPCKE-BENSON, Kristi EINERSON, Jean A MCBRIDE, Patrick E WIEBE, Donald A |
| description | Although total cholesterol concentrations measured by portable lipid analyzers have acceptable bias and precision in young and middle-aged adults, clinically relevant differences in HDL-cholesterol (HDL-C) and triglyceride values have been described. Furthermore, the accuracy of portable lipid analyzers in older hyperlipidemic individuals, who have a high incidence of coronary heart disease, has not been validated. This study determined the biases and variability in portable lipid measurements in older patients with hypercholesterolemia and related them to National Cholesterol Education Program Adult Treatment Panel III guidelines.
Participants were > or =70 years of age with fasting serum LDL-cholesterol (LDL-C) concentrations > 1.40 g/L. Fasting fingerstick samples were analyzed on a Cholestech L.D.X desktop analyzer. Antecubital venous samples were analyzed in a proficiency-certified clinical laboratory.
Portable measurements systematically overestimated triglycerides (0.296 g/L; P |
| format | Article |
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Participants were > or =70 years of age with fasting serum LDL-cholesterol (LDL-C) concentrations > 1.40 g/L. Fasting fingerstick samples were analyzed on a Cholestech L.D.X desktop analyzer. Antecubital venous samples were analyzed in a proficiency-certified clinical laboratory.
Portable measurements systematically overestimated triglycerides (0.296 g/L; P <0.001) and HDL-C (0.015 g/L; P = 0.026). LDL-C concentrations were underestimated (0.043 g/L; P = 0.046). Total and non-HDL cholesterol calculations based on the portable lipid device provided unbiased estimates, but wide variability was present. Significant variability in lipid determinations limited their clinical usefulness in individual patients, especially because 2 SD of the mean bias between the laboratory and the portable determinations of LDL-C and non-HDL cholesterol exceeded the 0.30 g/L cutoff that defines treatment targets in the current lipid guidelines.
Lipid values obtained from portable lipid analyzers may be useful for screening, but they should not be used to make clinical decisions regarding the diagnosis and management of dyslipidemia in individual patients.</description><identifier>ISSN: 0009-9147</identifier><identifier>EISSN: 1530-8561</identifier><identifier>PMID: 11805009</identifier><identifier>CODEN: CLCHAU</identifier><language>eng</language><publisher>Washington, DC: American Association for Clinical Chemistry</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood Chemical Analysis - instrumentation ; Blood Specimen Collection ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Fasting ; Humans ; Hypercholesterolemia - blood ; Hypercholesterolemia - diagnosis ; Investigative techniques, diagnostic techniques (general aspects) ; Lipids - blood ; Medical sciences ; Metabolic diseases ; Middle Aged ; National Health Programs ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Practice Guidelines as Topic ; Triglycerides - blood ; United States</subject><ispartof>Clinical chemistry (Baltimore, Md.), 2002-02, Vol.48 (2), p.284-290</ispartof><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13455070$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11805009$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>STEIN, James H</creatorcontrib><creatorcontrib>CARLSSON, Cynthia M</creatorcontrib><creatorcontrib>PAPCKE-BENSON, Kristi</creatorcontrib><creatorcontrib>EINERSON, Jean A</creatorcontrib><creatorcontrib>MCBRIDE, Patrick E</creatorcontrib><creatorcontrib>WIEBE, Donald A</creatorcontrib><title>Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercholesterolemia</title><title>Clinical chemistry (Baltimore, Md.)</title><addtitle>Clin Chem</addtitle><description>Although total cholesterol concentrations measured by portable lipid analyzers have acceptable bias and precision in young and middle-aged adults, clinically relevant differences in HDL-cholesterol (HDL-C) and triglyceride values have been described. Furthermore, the accuracy of portable lipid analyzers in older hyperlipidemic individuals, who have a high incidence of coronary heart disease, has not been validated. This study determined the biases and variability in portable lipid measurements in older patients with hypercholesterolemia and related them to National Cholesterol Education Program Adult Treatment Panel III guidelines.
Participants were > or =70 years of age with fasting serum LDL-cholesterol (LDL-C) concentrations > 1.40 g/L. Fasting fingerstick samples were analyzed on a Cholestech L.D.X desktop analyzer. Antecubital venous samples were analyzed in a proficiency-certified clinical laboratory.
Portable measurements systematically overestimated triglycerides (0.296 g/L; P <0.001) and HDL-C (0.015 g/L; P = 0.026). LDL-C concentrations were underestimated (0.043 g/L; P = 0.046). Total and non-HDL cholesterol calculations based on the portable lipid device provided unbiased estimates, but wide variability was present. Significant variability in lipid determinations limited their clinical usefulness in individual patients, especially because 2 SD of the mean bias between the laboratory and the portable determinations of LDL-C and non-HDL cholesterol exceeded the 0.30 g/L cutoff that defines treatment targets in the current lipid guidelines.
Lipid values obtained from portable lipid analyzers may be useful for screening, but they should not be used to make clinical decisions regarding the diagnosis and management of dyslipidemia in individual patients.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood Chemical Analysis - instrumentation</subject><subject>Blood Specimen Collection</subject><subject>Cholesterol, HDL - blood</subject><subject>Cholesterol, LDL - blood</subject><subject>Fasting</subject><subject>Humans</subject><subject>Hypercholesterolemia - blood</subject><subject>Hypercholesterolemia - diagnosis</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lipids - blood</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>National Health Programs</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Practice Guidelines as Topic</subject><subject>Triglycerides - blood</subject><subject>United States</subject><issn>0009-9147</issn><issn>1530-8561</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFj01LxDAYhIMobl39C5KLxy7pJmnSo1RdFwpe9uBteZu-pZF-hKRF6q-3YGVPwzDPDMwViRLJWaxlmlyTiDGWxVki1IbchfC1WKF0eks2SaKZXMKI-GMPxkwezEyHmrbW2Yp2CGHy2GE_Bvptx4aODVI3-BHKFmneDC2GEU1Di93L7pNCD-38g57anjoY7aXXzA69WXm_SGfhntzU0AZ8WHVLTm-vp_w9Lj4Ox_y5iJ3kWVwJYChMmTDQWkNdgkxFJhVfgixNa4mMKyUqsc_KvdCcKyPS5TevNUehBd-Sx79ZN5UdVmfnbQd-Pv9_X4CnFYBgoK099MaGC8eFlEwx_gvdkmSR</recordid><startdate>200202</startdate><enddate>200202</enddate><creator>STEIN, James H</creator><creator>CARLSSON, Cynthia M</creator><creator>PAPCKE-BENSON, Kristi</creator><creator>EINERSON, Jean A</creator><creator>MCBRIDE, Patrick E</creator><creator>WIEBE, Donald A</creator><general>American Association for Clinical Chemistry</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>200202</creationdate><title>Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercholesterolemia</title><author>STEIN, James H ; CARLSSON, Cynthia M ; PAPCKE-BENSON, Kristi ; EINERSON, Jean A ; MCBRIDE, Patrick E ; WIEBE, Donald A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p539-d4a0e4cb10a888afba5649573d4a966f5e03774d429b248337c468563f83e4843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood Chemical Analysis - instrumentation</topic><topic>Blood Specimen Collection</topic><topic>Cholesterol, HDL - blood</topic><topic>Cholesterol, LDL - blood</topic><topic>Fasting</topic><topic>Humans</topic><topic>Hypercholesterolemia - blood</topic><topic>Hypercholesterolemia - diagnosis</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Lipids - blood</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>National Health Programs</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Practice Guidelines as Topic</topic><topic>Triglycerides - blood</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>STEIN, James H</creatorcontrib><creatorcontrib>CARLSSON, Cynthia M</creatorcontrib><creatorcontrib>PAPCKE-BENSON, Kristi</creatorcontrib><creatorcontrib>EINERSON, Jean A</creatorcontrib><creatorcontrib>MCBRIDE, Patrick E</creatorcontrib><creatorcontrib>WIEBE, Donald A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Clinical chemistry (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>STEIN, James H</au><au>CARLSSON, Cynthia M</au><au>PAPCKE-BENSON, Kristi</au><au>EINERSON, Jean A</au><au>MCBRIDE, Patrick E</au><au>WIEBE, Donald A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercholesterolemia</atitle><jtitle>Clinical chemistry (Baltimore, Md.)</jtitle><addtitle>Clin Chem</addtitle><date>2002-02</date><risdate>2002</risdate><volume>48</volume><issue>2</issue><spage>284</spage><epage>290</epage><pages>284-290</pages><issn>0009-9147</issn><eissn>1530-8561</eissn><coden>CLCHAU</coden><abstract>Although total cholesterol concentrations measured by portable lipid analyzers have acceptable bias and precision in young and middle-aged adults, clinically relevant differences in HDL-cholesterol (HDL-C) and triglyceride values have been described. Furthermore, the accuracy of portable lipid analyzers in older hyperlipidemic individuals, who have a high incidence of coronary heart disease, has not been validated. This study determined the biases and variability in portable lipid measurements in older patients with hypercholesterolemia and related them to National Cholesterol Education Program Adult Treatment Panel III guidelines.
Participants were > or =70 years of age with fasting serum LDL-cholesterol (LDL-C) concentrations > 1.40 g/L. Fasting fingerstick samples were analyzed on a Cholestech L.D.X desktop analyzer. Antecubital venous samples were analyzed in a proficiency-certified clinical laboratory.
Portable measurements systematically overestimated triglycerides (0.296 g/L; P <0.001) and HDL-C (0.015 g/L; P = 0.026). LDL-C concentrations were underestimated (0.043 g/L; P = 0.046). Total and non-HDL cholesterol calculations based on the portable lipid device provided unbiased estimates, but wide variability was present. Significant variability in lipid determinations limited their clinical usefulness in individual patients, especially because 2 SD of the mean bias between the laboratory and the portable determinations of LDL-C and non-HDL cholesterol exceeded the 0.30 g/L cutoff that defines treatment targets in the current lipid guidelines.
Lipid values obtained from portable lipid analyzers may be useful for screening, but they should not be used to make clinical decisions regarding the diagnosis and management of dyslipidemia in individual patients.</abstract><cop>Washington, DC</cop><pub>American Association for Clinical Chemistry</pub><pmid>11805009</pmid><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Aged Aged, 80 and over Biological and medical sciences Blood Chemical Analysis - instrumentation Blood Specimen Collection Cholesterol, HDL - blood Cholesterol, LDL - blood Fasting Humans Hypercholesterolemia - blood Hypercholesterolemia - diagnosis Investigative techniques, diagnostic techniques (general aspects) Lipids - blood Medical sciences Metabolic diseases Middle Aged National Health Programs Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Practice Guidelines as Topic Triglycerides - blood United States |
| title | Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercholesterolemia |
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