What have we learnt about high-density lipoprotein cholesterol measurements during 32 years? Experiences in Finland 1980-2012

High-density lipoprotein cholesterol (HDL-C) is important in risk assessment for cardiovascular disease or metabolic syndrome; however, different direct HDL-C assays may lead to erroneous risk estimates and potentially misclassify people. Data for 30-year HDL-C trends in Finland were obtained from t...

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Bibliographic Details
Published in:Clinica chimica acta 2013-01, Vol.415, p.118-123
Main Authors: Leiviskä, Jaana, Sundvall, Jouko, Alfthan, Georg, Tähtelä, Riitta, Salomaa, Veikko, Jauhiainen, Matti, Vartiainen, Erkki
Format: Article
Language:English
Subjects:
Adult
Aged
Apolipoprotein A-I - blood
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cholesterol, HDL - blood
Enzyme Assays - standards
Enzyme Assays - statistics & numerical data
Female
Finland
Health Surveys
Humans
Immunoassay - standards
Immunoassay - statistics & numerical data
Longitudinal Studies
Male
Metabolic Syndrome - blood
Metabolic Syndrome - diagnosis
Middle Aged
Nephelometry and Turbidimetry - standards
Nephelometry and Turbidimetry - statistics & numerical data
Quality Control
Risk
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Summary:High-density lipoprotein cholesterol (HDL-C) is important in risk assessment for cardiovascular disease or metabolic syndrome; however, different direct HDL-C assays may lead to erroneous risk estimates and potentially misclassify people. Data for 30-year HDL-C trends in Finland were obtained from the national FINRISK surveys during 1982-2012 (n=45766) taking into account biases from three external quality assessment programs (EQA). We also compared two different direct HDL-C and turbidimetric apolipoprotein A-I methods using 413 fresh serum samples. HDL-C concentrations in the Finnish population were on average 1.33 (±0.04) mmol/l for men and 1.62 (±0.05) mmol/l for women after bias-correction. Positive HDL-C trends were observed for both sexes with original data, but trends disappeared after bias-correction. Comparison of two direct HDL-C methods demonstrated concentration-dependent difference. When HDL-C concentrations were 1.55 mmol/l showed mean bias of 9.0% (95% CI 7.0-10.5). Accurate reporting of HDL-C concentrations at the population level requires proper and regular attendance to reliable EQA programs. We found evidence for a concentration-dependent difference between some direct HDL-C methods, which may cause misclassification of people in cardiovascular risk assessment.
ISSN:1873-3492
DOI:10.1016/j.cca.2012.10.027