Calculated parameters of the lipidogram: modern scientific views and correlations with laboratory and instrumental indexes

Abstract

For prognostic evaluation of blood lipid profile There exist several calculated indexes for prognostic evaluation of blood lipid profile; however, it is not yet established, which integrative parameter is the most exact predictor of cardiovascular diseases. This fact makes our research feasible. Aim. To review modern scientific theories about calculated indexes of the lipidogram and to investigate correlations of these indexes with clinical, laboratory and instrumental parameters. Matherial and Methods. We have reviewed contemporary scientific points of view on calculated indexes of the lipidogram (28 references on this topic) and investigated correlations of these indexes with clinical, laboratory and instrumental parameters in 1140 patients of a diagnostic centre aged 18-89 years, which underwent various diagnostic procedures including lipidogram. The analyzed indexes and calculated parameters of the lipidogram (monocyte to high-density lipoproteins ratio, atherogenic index and coefficient, Castelli indexes I and II) correlated with some clinical, laboratory and instrumental parameters. Results and Discussion. Modern scientific points of view onthe indexed lipid parameters suggest that monocyte-to-high-density-lipoproteins ratio is an indicator of inflammation and oxidative stress, which together with endothelial dysfunction play a major role in the development of arterial hypertension and target organ damage; atherogenic index of the plasma is a sensitive indicator of atherosclerosis risk, which directly demonstrates the ratio of protective and atherogenic lipoproteins; atherogenic coefficient of A.M. Klimov, which is mainly used in post-Soviet countries, is a marker of progression of arterial hypertension; and Castelli risk indexes are non-direct criteria of the amount of particles of proatherogenic low density lipoproteins, tightly connected with atherosclerosis and cardiometabolic risk. Conclusion. According to our own analysis of 1140 lipidograms, atherogenic index had the biggest amount of associations including structural parameters of echocardiography. This fact makes atherogenic index the best for prognostic evaluation of not only lipid metabolism, but also of the heart condition. Associations of all the analyzed indexes with fasting glucose level underline the importance of its normalization for treatment and prevention of cardiovascular diseases. In case of normal absolute values of lipids calculation of atherogenic index (not atherogenic coefficient) allows to establish real blood atherogenicity and to reveal the group of patients which need statins. Active implementation of calculation of atherogenic index instead of more traditional for domestic healthcare institutions atherogenic coefficient of A.M. Klimov can facilitate comparison of Ukrainian scientists' data with foreign investigations results. It can also allow bringing received parameters to world standards.

Keywords

• atherogenic index, atherogenic coefficient, cholesterol, echocardiography, glucose