检查 由TC、甘油三酯、LDL、HDL和非HDL胆固醇组成。
可在非空腹状态下检测总胆固醇 (TC)、非 HDL 和 HDL。使用现代 Martin-Hopkins 公式时,在空腹和非空腹情况下都可准确估算 LDL 胆固醇水平,而 LDL 胆固醇水平较低时,使用旧方法(Friedewald 公式)通常会低估。[24]Sathiyakumar V, Park J, Golozar A, et al. Fasting versus nonfasting and low-density lipoprotein cholesterol accuracy. Circulation. 2018 Jan 2;137(1):10-9.http://www.ncbi.nlm.nih.gov/pubmed/29038168?tool=bestpractice.com非 HDL 胆固醇(使用 TC-HDL-C 公式计算得出)是心血管事件的独立标志物,可在非空腹状态下测定。[22]Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97.http://www.ncbi.nlm.nih.gov/pubmed/11368702?tool=bestpractice.com[23]Anderson TJ, Grégoire J, Pearson GJ, et al. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016 Nov;32(11):1263-82.http://www.ncbi.nlm.nih.gov/pubmed/27712954?tool=bestpractice.com
即使不存在疾病,TC值日间变异率达10%,而甘油三酯变异最高可达25%。[27]Cooper GR, Myers GL, Smith SJ, et al. Blood lipid measurements. Variations and practical utility. JAMA. 1992 Mar 25;267(12):1652-60.http://www.ncbi.nlm.nih.gov/pubmed/1542176?tool=bestpractice.com
血浆或血清均可用于测定,血浆胆固醇水平高于血清值大约3%左右。[28]Folsom AR, Kuba K, Luepker RV, et al. Lipid concentrations in serum and EDTA-treated plasma from fasting and nonfasting normal persons, with particular regard to high-density lipoprotein cholesterol. Clin Chem. 1983 Mar;29(3):505-8.http://www.clinchem.org/cgi/reprint/29/3/505http://www.ncbi.nlm.nih.gov/pubmed/6402325?tool=bestpractice.com
急性疾病可影响血脂水平。炎症状态下甘油三酯水平升高而胆固醇水平下降。急性心肌梗死后 24 小时,血脂水平变化尤其明显,因此测定应要么尽早及时进行要么推迟至恢复后。[29]Ryder RE, Hayes TM, Mulligan IP. How soon after myocardial infarction should plasma lipid values be assessed? Br Med J (Clin Res Ed). 1984 Dec 15;289(6459):1651-3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1443809/http://www.ncbi.nlm.nih.gov/pubmed/6439361?tool=bestpractice.com