Low serum total cholesterol (TC) in workers has been taken to indicate absence of cardiovascular (CV) risk.
In angiographically confirmed coronary artery disease TC has been shown to be less poignant than compound indices of cardiovascular risk in separating patients from controls.
The implications for prevention in an industrial medical setting of relying on TC measurements are discussed.
Employees (n=229) tested by an occupational health service in a non-manufacturing firm were dichotomized as low and high cardiovascular risk subjects either by the level of total cholesterol, or by two compound indices of blood lipid components.
The compound indices were : the TC/HDLc-ratio, and an'atherogenic index' (ATH-index) defined as ([TC-HDLc] x [apo B]) ? ([HDLC] x [apo A]). (apo A=apolipoprotein A-I, apo B=apolipoprotein B).
Cut-off values to separate between low-and high-risk subjects were defined as TC=6.0 mmol/l, HDLC=0.9 mmol/l, apo A=1.8 g/l and apo B=1.3 g/l, based on clinical guidelines in Norway.
These individual cut-off values gave TC/HDLC and ATH-index cut-off values of 6.7 and 4.1, respectively.
Assuming a more correct discrimination between persons at low-and high-risk, using compound lipid indices, both the number of persons given unnecessary advice on lifestyle changes or urged to take TC reducing medication, and the number of persons not treated on the basis of normal TC levels, would be reduced.
Percentages of persons classified as TC-level-low r...
Mots-clés Pascal : Cholestérol, Taux, Cholestérol HDL, Apolipoprotéine, Dépistage, Etude comparative, Appareil circulatoire, Risque élevé, Mesure, Médecine travail, Homme, Lipide
Mots-clés Pascal anglais : Cholesterol, Rate, Cholesterol HDL, Apolipoproteins, Medical screening, Comparative study, Circulatory system, High risk, Measurement, Occupational medicine, Human, Lipids
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0248673
Code Inist : 002B29C01. Création : 199608.