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Clinical Use of Apolipoprotein Quantitation
- A. Myron Johnson, MD;
- Wendy Y. Craig, MD; and
- Thomas B. Ledue, BA
- The Moses H. Cone Memorial Hospital; Greensboro, NC 27401-1020 Foundation for Blood Research; Scarborough, ME 04070-0190
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
The recent review of plasma apolipoproteins by Rader and colleagues [1] was thorough and generally excellent. We feel, however, that several points deserve comment. First, there are now international reference materials for apo A-I and apo B [2]. Manufacturers of immunochemical reagents and their related assay kits are currently converting to the values assigned to these reference materials. Admittedly, some differences will persist among methods and laboratories, but these should be substantially reduced after everyone has converted to the new values.
Second, the authors state that the British United Provident Association (BUPA) data [4] do not support using apo A-I levels compared with HDL cholesterol levels in population-based screening for coronary heart disease. However, the study showed that these two analytes did not significantly differ in screening performance and that neither was a good screening measurement.
Third, the statements about levels of apo B and Lp(a) found in the BUPA study are incorrect. A 10% decrease in apo B levels was associated with a 22% decrease (not increase) in the coronary artery disease mortality rate, and a 10% increase in Lp(a) levels was associated with a 3% increase (not decrease) in the risk for coronary heart disease.
One of the major conclusions of the BUPA study was that none of the lipid and lipoprotein variables measured—including levels of total cholesterol, triglycerides, HDL cholesterol, apo A-I, apo B, and Lp(a)—meet reasonable standards for use in population-based screening for coronary heart disease, either alone or in combination. The main conclusion of the study was that population-wide risk reduction is more likely to be effective in reducing the incidence of coronary heart disease than is an attempt to screen for “at-risk” persons [4].
A. Myron Johnson, MD
The Moses H. Cone Memorial Hospital; Greensboro, ND 27401-1020
Wendy Y. Craig, PhD
Thomas B. Ledue, BA
Foundation for Blood Research; Scarborough, ME 04070-0190
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
