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Association of Apolipoprotein B and Nuclear Magnetic Resonance Spectroscopy–Derived LDL Particle Number with Outcomes in 25 Clinical Studies: Assessment by the AACC Lipoprotein and Vascular Diseases Division Working Group on Best Practices
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- Thomas G Cole
- Thom Cole Consulting, LLC, St. Louis, MO
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- John H Contois
- Sun Diagnostics, LLC, New Gloucester, ME
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- Gyorgy Csako
- Department of Laboratory Medicine, NIH, Bethesda, MD
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- Joseph P McConnell
- Health Diagnostic Laboratory, Inc., Richmond, VA
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- Alan T Remaley
- Department of Laboratory Medicine, NIH, Bethesda, MD
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- Sridevi Devaraj
- Department of Clinical Chemistry, Texas Children's Hospital, Houston, TX
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- Daniel M Hoefner
- Health Diagnostic Laboratory, Inc., Richmond, VA
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- Tonya Mallory
- Health Diagnostic Laboratory, Inc., Richmond, VA
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- Amar A Sethi
- Pacific Biomarkers, Inc., Seattle, WA
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- G Russell Warnick
- Health Diagnostic Laboratory, Inc., Richmond, VA
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Description
<jats:sec> <jats:title>BACKGROUND</jats:title> <jats:p>The number of circulating LDL particles is a strong indicator of future cardiovascular disease (CVD) events, even superior to the concentration of LDL cholesterol. Atherogenic (primarily LDL) particle number is typically determined either directly by the serum concentration of apolipoprotein B (apo B) or indirectly by nuclear magnetic resonance (NMR) spectroscopy of serum to obtain NMR-derived LDL particle number (LDL-P).</jats:p> </jats:sec> <jats:sec> <jats:title>CONTENT</jats:title> <jats:p>To assess the comparability of apo B and LDL-P, we reviewed 25 clinical studies containing 85 outcomes for which both biomarkers were determined. In 21 of 25 (84.0%) studies, both apo B and LDL-P were significant for at least 1 outcome. Neither was significant for any outcome in only 1 study (4.0%). In 50 of 85 comparisons (58.8%), both apo B and LDL-P had statistically significant associations with the clinical outcome, whereas in 17 comparisons (20.0%) neither was significantly associated with the outcome. In 18 comparisons (21.1%) there was discordance between apo B and LDL-P.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>In most studies, both apo B and LDL-P were comparable in association with clinical outcomes. The biomarkers were nearly equivalent in their ability to assess risk for CVD and both have consistently been shown to be stronger risk factors than LDL-C. We support the adoption of apo B and/or LDL-P as indicators of atherogenic particle numbers into CVD risk screening and treatment guidelines. Currently, in the opinion of this Working Group on Best Practices, apo B appears to be the preferable biomarker for guideline adoption because of its availability, scalability, standardization, and relatively low cost.</jats:p> </jats:sec>
Journal
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- Clinical Chemistry
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Clinical Chemistry 59 (5), 752-770, 2013-05-01
Oxford University Press (OUP)
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Details 詳細情報について
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- CRID
- 1360292621577746688
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- ISSN
- 15308561
- 00099147
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- Data Source
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- Crossref