title: Comparison of cardiometabolic risk biomarkers from a national clinical laboratory with the US adult population.
abstract: BACKGROUND
  Clinical laboratory patient databases are an untapped source of valuable diagnostic and prognostic information. However, the lack of associated clinical and/or demographic information and questionable generalizability to nonpatient populations often limit utility of these data.
  
  
  OBJECTIVE
  This study compared levels of cardiometabolic biomarkers between a national clinical laboratory patient cohort (Health Diagnostic Laboratory [HD Lab]) and the US population as inferred from the National Health and Nutrition Examination Survey (NHANES, 2011-2012).
  
  
  METHODS
  Sample sizes for HD Lab ranged from 199,000 to 739,000 and for NHANES from 2200 to 5300. The latter were weighted to represent the adult US population (∼220 million). Descriptive statistics were compared for body mass index, 5 lipid biomarkers, and 3 glycemic biomarkers.
  
  
  RESULTS
  Using age- and sex-matched data, mean biomarker values (mg/dL unless noted) and percent differences (%) for HD Lab vs NHANES were body mass index (kg/m(2)), 29.1 vs 28.6 (1.7%); total cholesterol, 185 vs 193 (-4.1%); apolipoprotein B, 92 vs 90 (2.2%); low-density lipoprotein cholesterol, 107 vs 115 (-7%); high-density lipoprotein cholesterol, 53 vs 53 (0%); triglycerides, 128 vs 127 (0.8%); glucose, 99 vs 108 (-8.3%); insulin (uU/mL), 13.7 vs 13.4 (2.2%); and hemoglobin A1c (%), 5.6 vs 5.8 (-3.4%). Although all differences were statistically significant, only low-density lipoprotein cholesterol and glucose differed by more than 5%. These may reflect a greater use of medications among HD Lab patients and/or preanalytical factors.
  
  
  CONCLUSIONS
  Cardiometabolic risk markers from a national clinical laboratory were broadly similar to those of the US population; thus, with certain caveats, data from the former may be generalizable to the latter.
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Elliott
authors.initials: E
authors.lastname: Wolin
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: White
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
authors.forename: James V
authors.initials: JV
authors.lastname: Pottala
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Maciek
authors.initials: M
authors.lastname: Sasinowski
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Dall
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Dayspring
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: McConnell
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Hoefner
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Varvel
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Thiselton
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA.
authors.forename: G Russell
authors.initials: GR
authors.lastname: Warnick
authors.affiliation: Department of Research and Development, Health Diagnostic Laboratory, Inc., Richmond, VA, USA; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA. Electronic address: bharris@hdlabinc.com.
authors.forename: William S
authors.initials: WS
authors.lastname: Harris
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D019411:Clinical Laboratory Techniques; D005260:Female; D006306:Health Surveys; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D009749:Nutrition Surveys; D012307:Risk Factors; D014481:United States
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids
keywords: Biomarkers; Cardiovascular risk; Clinical laboratory; Lipids; NHANES; US population