Accuracy of Non-fasting Lipid Profile for the Assessment of Lipoprotein Coronary Risk. | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2016]

Author(s):

1. Safia Fatima: Department of Chemical Pathology and Endocrinology, AFIP, Rawalpindi, Pakistan; National University of Medical Sciences, Islamabad, Pakistan

2. Aamir Ijaz: Department of Chemical Pathology and Endocrinology, AFIP, Rawalpindi, Pakistan; National University of Medical Sciences, Islamabad, Pakistan

3. Tariqbin Sharif: Department of Chemical Pathology and Endocrinology, AFIP, Rawalpindi, Pakistan; National University of Medical Sciences, Islamabad, Pakistan

4. Dilshad Ahmad Khan: Department of Chemical Pathology and Endocrinology, AFIP, Rawalpindi, Pakistan; National University of Medical Sciences, Islamabad, Pakistan

5. Amer Siddique: Department of Chemical Pathology and Endocrinology, AFIP, Rawalpindi, Pakistan; National University of Medical Sciences, Islamabad, Pakistan

Abstract:

Objective: : To determine the diagnostic accuracy of non-fasting lipid profile in the diagnosis of hyperlipidemia, taking fasting lipid profile as gold standard, in adult population. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from July to December 2014. Methodology: One hundred seventy-five adult patients coming for fasting lipid profile were included; their non-fasting samples were taken on the next day. Patients on anti-cholesterol treatment and indoor patients were excluded. Total cholesterol (TC), high density lipoprotein-cholestrol (HDL-C), and triglycerides were measured by direct enzymatic colorimetric method by Modular p-800®. Low density lipoprotein-cholesterol (LDL-C) was calculated by Friedewald's formula, but when triglyceride was greater than 4.5 mmol/l, then LDL-C was measured directly by homogenous enzymatic colorimetric method. Non-HDL-C was calculated by simple equation, i.e. TC-HDL-C. Results: Non-fasting lipid profile had 93% specificity , 51% sensitivity, 94% positive predictive value and 49% negative predictive value; and 65% accuracy with 7.28 positive likelihood ratio and 0.52 negative likelihood ratio. Non-fasting TC and non-HDL-C were significantly higher than fasting TC and non-HDL-C by mean difference of 0.2 mmol/l each with p=0.001 and p=0.004, respectively. Fasting and non fasting HDL-C are comparable to each other with mean difference of 0.01 mmol/l (p=0.745). Receiver operating curve (ROC) of non-fasting non-HDL-C showed 0.804 (95%CI (0.738-0.870), (p=0.000) area under the curve (AUC) indicating that it was a significant test for ruling out hyperlipidemia. Bland-Altmann plot showed a significant difference between non-fasting, non-HDL-C and fasting LDL-C and non-fasting, non-HDL-C -0.087540 with bias -0.00109; therefore, these cannot be alternative to each other. Conclusion: Diagnostic accuracy of non-fasting lipid profile was found significantly higher than fasting lipid profile (p=0.004) for the assessment of lipoprotein coronary risk on the basis of non-HDL-C, which seemed to be significant test for ruling out hyperlipidemia.

Page(s): 6-7

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 26, Issue: 12, Year: 2016

Keywords:

Keywords are not available for this article.

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