Variación biológica de lípidos y lipoproteínas séricas en individuos sanos y pacientes con enfermedad renal crónica terminal

Abstract

Introduction: Cardiovascular diseases are a major cause of morbidity and mortality in both the general population and in patients with end stage renal disease (ESRD), with dyslipidemia being the one of the main associated risk factors. A correct interpretation of the lipid profile can only be made when the within- and between-subject biological variation is taken into account. In this study the biological variation data has been estimated for serum lipids and lipoproteins in healthy individuals and ESRD patients, and these data were then used to define the reference value change (RVC), the index of individuality, and the analytical goals. Material and methods: Serum samples were collected from 18 ESRD patients in steady-state conditions, one per month during 6 months, and from 11 healthy volunteers at weekly intervals over 5 weeks. Biological variation data were derived using ANOVA. Results: Triglycerides and VLDL cholesterol concentrations were significantly higher in ESRD patients than in healthy individuals, whereas HDL cholesterol concentration was significantly lower. However, no differences were observed in the biological variation data and, consequently, the derived RVCs, index of individualiy and analytical goals were similar. Conclusions: The use of the RVC derived from healthy individuals is appropriate in the monitoring of dyslipidemia in ESRD patients. Asymmetric RVC, according to the non-Gaussian distribution of serum concentrations in both groups, would enable the response to the hypolipemiant treatment in dyslipidemic individuals to be assessed more accurately.