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Abstract
By using National Cholesterol Education Program guidelines for serum cholesterol (<200
mg/dl is designated “desirable,” and 200 to 239 mg/dl is designated “borderline-high,”
and ≥240 mg/dl is designated “high”), low-density and high-density lipoprotein (LDL,
HDL) cholesterol levels and triglyceride levels were quantitated in 897 self-referred
fasting subjects to assess the potential for coronary risk misclassification. With
cholesterol <200 mg/dl, misclassification was arbitrarily identified by an LDL level
≥ the 75th percentile, a triglyceride level ≥ the 90th percentile, or an HDL level
≤ the 10th percentile. With the cholesterol level in the 200 to 239 mg/dl range, misclassification
was identified by an LDL level ≥ the 75th percentile, a triglycéride level ≥ the 90th
percentile, and an HDL level ≤ the 10th percentile or ≥ the 90th percentile (or both).
With a cholesterol level ≥240 mg/dl, misclassification was identified by an HDL level
≤ the 10th percentile, or ≥ the 90th percentile. With the cholesterol level <200 mg/dl,
misclassification is rare, occurring in 14.5% of the subjects. With the cholesterol
level in the 200 to 239 mg/dl range, and ≥240 mg/dl, misclassification occurred in
46.7% and 17.6% of the subjects, respectively. The importance of routine lipoprotein
analysis when the cholesterol level is ≥240 mg/dl is emphasized by the finding that
65% of the subjects in this category had top quartile LDL levels, 8% had bottom decile
HDL levels, and 30% had top decile triglyceride levels. To avoid misclassification,
fasting HDL, LDL, and triglyceride levels should probably be measured in all subjects
with screening cholesterol levels ≥200. There is remarkably little misclassification
with top quartile LDL or bottom decile HDL levels (or both) when the cholesterol level
is <200 mg/dl.
Abbreviations:
CHD = coronary heart disease (), HDL = high-density lipoprotein (), LDL = low-density lipoprotein (), TC = total serum cholesterol ()To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
November 4,
1988
Received in revised form:
November 1,
1988
Received:
July 1,
1987
Identification
Copyright
© 1989 Published by Elsevier Inc.
