Lipid re-screening: what is the best measure and interval?
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...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2010
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| _version_ | 1797050205345939456 |
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| author | Takahashi, O Glasziou, P Perera, R Shimbo, T Suwa, J Hiramatsu, S Fukui, T |
| author_facet | Takahashi, O Glasziou, P Perera, R Shimbo, T Suwa, J Hiramatsu, S Fukui, T |
| author_sort | Takahashi, O |
| collection | OXFORD |
| description | 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. |
| first_indexed | 2024-03-06T18:01:43Z |
| format | Journal article |
| id | oxford-uuid:0002dc43-f177-4664-91ca-6d6ba2d9bfef |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:01:43Z |
| publishDate | 2010 |
| record_format | dspace |
| spelling | oxford-uuid:0002dc43-f177-4664-91ca-6d6ba2d9bfef2022-03-26T08:27:09ZLipid re-screening: what is the best measure and interval?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0002dc43-f177-4664-91ca-6d6ba2d9bfefEnglishSymplectic Elements at Oxford2010Takahashi, OGlasziou, PPerera, RShimbo, TSuwa, JHiramatsu, SFukui, T 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. |
| spellingShingle | Takahashi, O Glasziou, P Perera, R Shimbo, T Suwa, J Hiramatsu, S Fukui, T Lipid re-screening: what is the best measure and interval? |
| title | Lipid re-screening: what is the best measure and interval? |
| title_full | Lipid re-screening: what is the best measure and interval? |
| title_fullStr | Lipid re-screening: what is the best measure and interval? |
| title_full_unstemmed | Lipid re-screening: what is the best measure and interval? |
| title_short | Lipid re-screening: what is the best measure and interval? |
| title_sort | lipid re screening what is the best measure and interval |
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