Classification of LDL Phenotypes by 4 Methods of Determining Lipoprotein Particle Size. (August 2013)

• Record Type: Journal Article
• Authors: Sninsky, John J.; Rowland, Charles M.; Baca, Arthur M.; Caulfield, Michael P.; Superko, Harold Robert
• Is Part Of: Journal of investigative medicine. Volume 61:Number 6(2013)
• Page Start: 942
• Page End: 949
• Publication Date: 2013-08
• Subjects: LDL phenotype -- triglyceride -- HDL-C -- triglyceride/HDL-C ratio -- LDL subfraction methods; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.2310/JIM.0b013e31829d9d17
• Languages: English
• ISSNs: 1081-5589

Abstract

Background: Low-density lipoprotein cholesterol (LDL-C) lowering is the primary objective of patient management for cardiovascular disease. However, large numbers of patients who have achieved their LDL-C goal remain at risk for cardiovascular events. Low-density lipoprotein subfractions may provide insight into this residual risk. Thus, LDL subfraction standardization and consistency are critical to these efforts. Aim: This study aimed to determine the agreement of the analytical results among 4 methods commonly used for LDL subfractionation, namely, segmented gradient gel electrophoresis (sGGE), ultracentrifugation-vertical auto profile (VAP), nuclear magnetic resonance (NMR), and ion mobility (IM). Methods: Blood samples were collected from 228 apparently healthy adults and sent to 4 clinical reference laboratories for analysis. The LDL phenotype was reported as pattern A (larger, less dense particles) or pattern B (smaller, more dense particles), respectively, and was the primary measure of comparison. An intermediate pattern (A/B) was also reported for sGGE and VAP. Results: We observed complete agreement in the LDL phenotype among the 4 methods in 64% of subjects and agreement among at least 3 of the 4 methods in 87% of subjects. Agreement among pairs of methods ranged from 73% to 98% depending on how differences in reporting of subjects with intermediate results were considered. When subjects having intermediate A/B pattern were excluded, sGGE and IM had the highest agreement (98%) of any pair of methods. Conclusions: We found substantial agreement in the reported LDL phenotype among 4 LDL subfraction measurement technologies as performed by different clinical reference laboratories.