SEQC Spanish Society of Laboratory Medicine

Spanish Society of Laboratory Medicine

Experts produce a Spanish consensus on recommended values for the lipid profile

Under the auspices of the scientific societies for Arteriosclerosis, Primary Care, Cardiology, Family and Community Medicine, and Laboratory Medicine

  • Currently, there is variability in lipid values ​​considered to be advisable by clinical laboratories, which may generate confusion and pose a barrier to the correct treatment of dyslipidaemias
  • The document´s aim is to recommend to all clinical laboratories the adoption of homogeneous recommended values ​for the variables that make up the lipid profile
  • This consensus includes wide-reaching and documented information, such as epidemiological data for our country, existing barriers to achieving control of dyslipidaemia and strategies to avoid them, and recommendations on which values ​​of lipid constituents should be reported as altered
  • In Spain, it is estimated that 48% of men and 52% of women over 18 years of age have high total cholesterol levels, while 23% of men and 12% of women have hypertriglyceridemia

Alterations in circulating lipid concentrations (total cholesterol and its high --HDL-- and low --LDL-- density and triglycerides fractions), commonly referred to as dyslipemias, correlate with the development of cardiovascular diseases of ischemic origin. Thus, numerous studies have shown that interventions that "normalize" circulating lipid concentrations protect against these diseases.

However, in Spain, there is no unanimous agreement on circulating lipid concentrations that can be considered as "baseline" or "recommended" and, therefore, used to define dyslipidaemia when they are altered.

In addition, the recommendations in international literature are based on population studies that are not universally applicable. For this reason, the reference or recommended values ​​that accompany analytical laboratory reports may vary between different clinical laboratories.

This variability can create confusion among clinicians who receive laboratory results and may be a barrier to the correct treatment of lipid abnormalities (or dyslipidaemias) and reduction of ischemic cardiovascular disease.

Recently, the European Society of Arteriosclerosis (EAS) and Cardiology (ESC) have developed a recommendation for the control of dyslipidemia, which includes several novel aspects. One of them is the non-need for fasting to obtain the lipid profile, which requires the varying of concentrations of triglycerides that are considered desirable.

Faced with this situation, a group of professionals has developed the consensus document 'Homogenization of lipid profile values', under the auspices of the five scientific societies of which they are part: Spanish Society of Arteriosclerosis, Spanish Society of Primary Care Physicians, Spanish Society of Cardiology, Spanish Society of Family and Community Medicine, and Spanish Society of Laboratory Medicine.

"The objective of creating this consensus is to recommend to all laboratories the adoption of homogeneous values, considered as recommended, for the variables that make up the lipid profile," says Dr. Jordi Ordóñez Llanos, one of the authors of the work and member of the Spanish Society of Laboratory Medicine (SEQCML).

According to this expert, this consensus not only reflects the recommendations of the EAS-ESC, but also includes epidemiological information for our country, and the details of the pre-analytical, analytical and post-analytic sources of variation that may influence lipid concentrations or their evaluation; it also identifies the barriers that exist to achieving control of dyslipidaemia, and recommends strategies to avoid them. "In addition," he adds, "it establishes a recommendation for the lipid constituents that the lipid profile should include and, very importantly, what values ​​of the same should be reported as altered in the analytical report provided by clinical laboratories. In addition, it establishes values for blood tests obtained both with and without fasting ".

The consensus is directed particularly at clinical laboratory specialists and recommends, in particular, the adoption by the laboratories of limit values ​​to consider the concentrations of circulating lipids as altered. "Although it is also useful for any medical professional who has responsibility in the diagnosis, treatment, and treatment monitoring of dyslipemias," concludes Dr. Ordóñez.

High prevalence

Different studies estimate that in our country, 48% of men and 52% of women older than 18 years of age have total cholesterol levels above 200 mg/dL, while hypertriglyceridemia (triglycerides> 150 mg/dL, 1.67 mmol/L) occurs in 23% of men and 12% of women.