A multicenter study on the precision and accuracy of homogeneous assays for LDL-cholesterol: Comparison with a beta-quantification method using fresh serum obtained from non-diseased and diseased subjects

Takashi Miida, Kunihiro Nishimura, Tomonori Okamura, Satoshi Hirayama, Hirotoshi Ohmura, Hiroshi Yoshida, Yoh Miyashita, Masumi Ai, Akira Tanaka, Hiroyuki Sumino, Masami Murakami, Ikuo Inoue, Yuzo Kayamori, Masakazu Nakamura, Tsutomu Nobori, Yukihisa Miyazawa, Tamio Teramoto, Shinji Yokoyama

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31 Citations (Scopus)

Abstract

Background: Homogeneous assays for low-density lipoprotein-cholesterol (LDL-C) have good precision and are pretreatment-free procedures. However, their accuracies have been questioned, especially in diseased subjects. In this study, we aimed to verify whether LDL-C levels determined by homogeneous assays [LDL-C (H)] agree with those determined by a beta-quantification method [LDL-C (BQ)] in fresh clinical samples. Methods: We determined LDL-C levels in 49 non-diseased and 124 diseased subjects whose triglyceride (TG) levels were less than 11.29 mmol/L (1000 mg/dL) using 12 homogeneous assays and a BQ method simultaneously. Results: In total, 30.6% of non-diseased subjects and 46.0% of diseased subjects were in the postprandial state. The maximum inter- and intra-assay CVs were 1.8% and 1.5%, and 8 reagents had a CV of 1.0% or less. The mean bias ranged from -0.5% to 1.8% for non-diseased subjects and from -0.7% to 1.6% for diseased subjects. For non-diseased subjects, all but one reagent achieved the National Cholesterol Education Program (NCEP) total error requirement in more than 90% of samples. However, for diseased subjects, the number of reagents that met this requirement was low. With some reagents, LDL-C (H) was higher than LDL-C (BQ), especially in subjects with hypertriglyceridemia. While for other reagents, the difference between the two methods was not associated with hypertriglyceridemia except for type I (n = 2) and type III hyperlipidemia (n = 1). Postprandial sampling was not the main factor for discordant results. Conclusions: LDL-C (H) agrees with LDL-C (BQ) in non-diseased subjects, but exhibits positive bias for subjects with hypertriglyceridemia in diseased subjects for some reagents.

Original languageEnglish
Pages (from-to)208-215
Number of pages8
JournalAtherosclerosis
Volume225
Issue number1
DOIs
Publication statusPublished - 2012 Nov 1

Keywords

  • Beta-quantification
  • Direct LDL-C assay
  • Friedewald equation
  • Hypertriglyceridemia
  • Lipoprotein assay
  • Standardization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Miida, T., Nishimura, K., Okamura, T., Hirayama, S., Ohmura, H., Yoshida, H., Miyashita, Y., Ai, M., Tanaka, A., Sumino, H., Murakami, M., Inoue, I., Kayamori, Y., Nakamura, M., Nobori, T., Miyazawa, Y., Teramoto, T., & Yokoyama, S. (2012). A multicenter study on the precision and accuracy of homogeneous assays for LDL-cholesterol: Comparison with a beta-quantification method using fresh serum obtained from non-diseased and diseased subjects. Atherosclerosis, 225(1), 208-215. https://doi.org/10.1016/j.atherosclerosis.2012.08.022