{"id":6175,"date":"2020-08-11T09:07:34","date_gmt":"2020-08-11T08:07:34","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6175"},"modified":"2021-04-16T12:57:38","modified_gmt":"2021-04-16T11:57:38","slug":"non-hdl-or-ldl-cholesterol-in-heterozygous-familial-hypercholesterolaemia-findings-of-the-simon-broome-register-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/08\/11\/non-hdl-or-ldl-cholesterol-in-heterozygous-familial-hypercholesterolaemia-findings-of-the-simon-broome-register-2020\/","title":{"rendered":"Non-HDL or LDL cholesterol in heterozygous familial hypercholesterolaemia: findings of the Simon Broome Register (2020)"},"content":{"rendered":"

Type of publication:<\/strong>
\nJournal article<\/p>\n

Author(s):<\/strong>
\nSoran H.; Durrington P.N.; Cooper J.A.; Humphries S.E.; *Capps N.; McDowell I.F.W.; Neil A.<\/p>\n

Citation:<\/strong>
\nCurrent Opinion in Lipidology; August 2020, Volume 31, Issue 4, p. 167-175<\/p>\n

Abstract:<\/strong>
\nPURPOSE OF REVIEW: The role of non-HDL-C in the identification and management of lipid disorders is not clearly defined, although UK guidelines recommend its wider use in assessing the need for lipid-lowering therapy and as a treatment target. RECENT FINDINGS: We examined the implications of the use of non-HDL-C as opposed to LDL-C in 253 people with hypercholesterolaemia before treatment and 573 after treatment in whom fasting total serum cholesterol, HDL-C and LDL-C had been recorded and the diagnosis of heterozygous familial hypercholesterolemia (heFH) was investigated by genetic testing. The difference and the limits of agreement between non-HDL-C and LDL-C calculated using the Friedewald formula were assessed in those with and without heFH-causing mutations. SUMMARY: There were 147 mutation-positive and 106 mutation-negative pretreatment participants and 395 mutation-positive and 178 mutation-negative patients receiving treatment. The difference between non-HDL-C and LDL-C pretreatment in mutation-positive people (mean LDL-C 7.73 mmol\/l) was 0.67 mmol\/l (95% CI 0.62-0.73) and posttreatment (mean LDL-C 4.71 mmol\/l) was 0.62 mmol\/l (95% CI 0.59-0.65) with wide limits of agreement of -0.02 to 1.37 and 0.07-1.18 mmol\/l, respectively. Among patients with heterozygous familial hypercholesterolaemia, use of estimated LDL-C derived from non-HDL-C in place of calculated LDL-C may result in diagnostic misclassification and difficulty in assessing the true reduction in LDL-C with treatment, because of the wide inter-individual limits of agreement around the mean difference between non-HDL-C and LDL-C.<\/p>\n

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