Oğuz KÖKTÜRK, Ulukavak Tansu ÇİFTÇİ, Serap FIRAT, Hikmet FIRAT

HDL/LDL ratio: a useful parameter for separation of pleural transudates from exudates

Plevral efüzyonların tanısını koymada ilk basamak transüda-eksüda ayrımının yapılmasıdır. Çalışmamızda, plevral sıvıda hesaplanan HDL/LDL oranının transüda-eksüda ayrımındaki yerini araştırmayı amaçladık. Yirmisekizi transüda, 93’ü eksüda olmak üzere 121 plevral sıvı analiz edildi. Plevra sıvılarında kolesterol, HDL ve LDL düzeyleri ölçüldü. HDL/LDL oranı hesaplandı. HDL/LDL oranı transüdalarda eksüdalara oranla anlamlı ölçüde yüksek bulundu (p= 0.001). “Receiver Operating Characteristic (ROC)” eğrisi ile “cut-off” değer bulundu. HDL/LDL oranının maksimum sensitivite ve spesifisite ile transüda tanısı koyduran değeri saptandı. Transüdaları eksüdalardan ayıran HDL/LDL oranı 0.6 olarak belirlendi (sensitivite: %89, spesifisite %79). Plevral sıvılarda HDL ve LDL ölçümü ile HDL/LDL oranı hesaplanması, serum örneği almaya gerek kalmadan transüda-eksüda ayrımının yapılmasında uygun bir yöntemdir.

HDL/LDL oranı: Transüda-eksüda ayrımında kullanışlı bir parametre

The first diagnostic step in pleural effusions is the separation of transudates from exudates. We aimed in present study to investigate the value of HDL/LDL ratio for distinguishing between pleural exudates and transudates. Pleural fluids (PF) from 121 patients, including 28 transudates and 93 exudates were analyzed. The levels of cholesterol, HDL cholesterol and LDL cholesterol in PF were measured. The HDL/LDL ratio was calculated. HDL/LDL ratio found significantly higher in transudates than exudates (p= 0.001). Receiver operating characteristic (ROC) curves were generated and the cut off points determined to the highest level of accuracy and precision. The HDL/LDL ratio was to maximize sensitivity over specificity in the diagnosis of a transudative effusion. The usefulness of HDL/LDL ratio for identifying transudates was evaluated in terms of sensitivity and specificity. The value of pleural HDL/LDL ratio that best differentiated between transudates and exudates was 0.6 (sensitivity 89%, and specificity of 79%). Measurement of HDL and LDL in PF and calculating of HDL/LDL ratio can be proposed to aid for differentiation between pleural exudates and transudates with advantage of not requiring serum levels.

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