不同公式估算台灣成年人低密度脂蛋白膽固醇之效能比較

Comparison of the Efficiencies of Various Formulae for Estimating Low Density Lipoprotein-Cholesterol in Adult Taiwanese

蔡崇煌(Chung-Huang Tsai) ； 林恆宇(Heng-Yu Lin) ； 王雪芳(Hsueh-Fang Wang) ； 王瑞蓮(Jui-Line Wang) ； 林高德(Gau-De Lin) ； 林俊隆(Jiunn-Lung Lin)

《臺灣營養學會雜誌》 37卷4期 (2012/12) Pp. 119-127

https://doi.org/10.6691/NSJ.201212_37(4).0001

摘要

推估低密度脂蛋白膽固醇（low density lipoprotein-cholesterol; LDL-C）有數種公式，但少有不同公式間的比較，本研究比較數種公式效能，探討何者較適合國人使用。收集2011年1月至12月健康檢查，禁食8小時以上且有完整血脂肪檢查者共3532個案，年齡為20～95歲，男性佔2152人（60.9%）。檢驗項目包括總膽固醇、高密度脂蛋白膽固醇、LDL-C及三酸甘油酯（triglyceride; TG）。以LDL-C實測值與推估值之線性關係及估計誤差，比較不同公式之估計效率，使用SAS 9.2分析。結果顯示FF的效度較差；但其在TG 400 mg/dL內亦有好的表現，其決定係數（coefficient of determination; R2）可達0.9256，但還是比其他公式差。表現最好者為多元線性迴歸（TMR），其次為蔡氏公式（TF）、校準之TF（CTF）及Teerakanchana的MR 公式，其R2都高達0.95 以上；三個估計式之間沒有明顯的差異。再者，無論對所有個案或TG 400 mg/dL個案，TF、CTF及Teerakanchana 的LDL-C估計值與檢測值皆相近，表示它們不只適用於TG 400mg/dL的範圍。然MR之公式複雜，若從應用簡便性考量，則以TF最優。因此可見FF有其不準確性，各種公式中，TF簡易且有較好的效度，此或可資國人臨床上之應用。

關鍵字

低密度脂蛋白膽固醇 ； 迴歸 ； 殘餘膽固醇 ； Teerakanchana ； 三酸甘油酯

並列摘要

There are various formulae for estimating low density lipoprotein-cholesterol (LDL-C), while there are few studies comparing them. This study compared the efficiencies of various formulae for estimating LDL-C to determine which formula might give more accurate estimations. A total of 3532 physical-checkup cases, with fasting for more than 8 hours, aged 20-95 years, 60.9% male, were collected from January to December 2011. Total cholesterol, high density lipoprotein-cholesterol, LDL-C, and triglyceride (TG) were determined by enzymatic colorimetric methods. We compared their efficiencies using a linear relationship and prediction errors of measuring the LDL-C and estimating the LDL-C. SAS 9.2 was used to perform the statistical analyses. The Friedewald's formula (FF) had poor validity, but it had a good result with a coefficient of determination(R^2)that reached 0.9256 for cases with TG of ≤ 400 mg/dL, which, however, was still smaller than the others. The multiple linear regression model had best performance, followed by Tsai's formula (TF), the calibration of TF(CTF), and Teerakanchana's formula. All R^2 values were ＞ 0.95, and there were no significant differences among them. The values of all cases or of cases with TG of ≤ 400 mg/dL were similar among TF、CTF and Teerakanchana's formula, which means that it is not just suitable for cases with TG of ≤ 400 mg/dL. TF was best because the coefficient of the multiple regression equations was more complicated. The FF was not unbiased when estimating LDL-C, while TF was simpler and more accurate. TF can be used to estimate LDL-C for Taiwanese adults.

並列關鍵字

LDL-C ； regression ； residual cholesterol ； Teerakanchana ； triglyceride