Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Serum Total Kolesterol Referans Sınırlarının Aykırı Değer Analizi ile İncelenmesi: Metodolojik Çalışma
Examination of Serum Total Cholesterol Reference Limits with Outlier Analysis: A Methodological Study
İsmet DOĞANa , Tülay KÖKENb
aAfyonkarahisar Sağlık Bilimleri Üniversitesi Tıp Fakültesi, Biyoistatistik AD, Afyonkarahisar, Türkiye
bAfyonkarahisar Sağlık Bilimleri Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya AD, Afyonkarahisar, Türkiye
Turkiye Klinikleri J Med Sci. 2025;45(1):1-7
doi: 10.5336/medsci.2024-102657
Article Language: TR
Full Text
ÖZET
 Amaç: Serum kolesterol düzeyinin yüksek olması kalp damar hastalığı riskini arttırır. Serum kolesterol referans değerleri riskin belirlenmesinde önem taşır. Bu makalenin amacı, serum total kolesterol için referans sınırları aykırı değer yaklaşımı ile değerlendirmektir. Gereç ve Yöntemler: Bu çalışmada total kolesterol için sınır değerlerin bulunmasında Box-Plot yöntemi kullanılmıştır. Yöntem aşırı istatistik bilgi gerektirmeyen, istatistik tabloların kullanılmasına ihtiyaç duymayan, yorumlanması ve uygulanması kolay bir yöntem olduğu için tercih edilmiştir. Veriler, herhangi bir sebeple 1 Ocak 2023-11 Aralık 2023 tarihleri arasında bir üniversite hastanesi polikliniklerine farklı nedenlerle başvurmuş, başvuru sonrası bir kısmı tanı almış, bir kısmı ise herhangi bir tanı almamış olan 1-93 arası yaşlara sahip 24.782'si kadın, 1-97 arası yaşlara sahip 17.403'ü erkek olmak üzere toplam 42.185 kişinin arşiv bilgilerinden yararlanarak retrospektif olarak elde edilmiştir. Bulgular: Elde edilen bulgulara göre erkek çocuk ve adölesanlar için total serum kolesterol değerinin sınıflandırılması ≤62 düşük, 63- 169 kabul edilebilir, 170-199 sınırda yüksek, 200-228 yüksek ve ≥229 çok yüksek şeklinde belirlenmiştir. Yetişkin erkekler için ise bu sınıflar sırasıyla ≤55 düşük, 56-199 kabul edilebilir, 200-239 sınırda yüksek, 240-289 yüksek ve ≥290 çok yüksek şeklindedir. Kadınlar için adölesan ve çocuklarda ≤71 düşük, 72-169 kabul edilebilir, 170-199 sınırda yüksek, 200-225 yüksek ve ≥226 çok yüksek şeklinde belirlenmiştir. Yetişkin kadınlar için ise bu sınıflar sırasıyla ≤72 düşük, 73-199 kabul edilebilir, 200-239 sınırda yüksek, 240-295 yüksek ve ≥296 çok yüksek şeklindedir. Sonuç: Klinik değerlendirmelerde kesim değeri (cutoff) kullanılmakla beraber alt ve üst referans değerlerin de dikkate alınması gereklidir. Serum total kolesterolü için çalışmadan elde edilen referans sınırlar daha net ve hekimlerin tanı koymak için kullanabileceği daha spesifik değerlerdir.

Anahtar Kelimeler: Serum total kolesterol; aykırı değer analizi; referans sınırlar; parametrik olmayan yöntem
ABSTRACT
 Objective: High serum cholesterol levels increase the risk of cardiovascular disease. Serum cholesterol reference values are important in determining the risk. The aim of this article is to evaluate the reference limits for serum total cholesterol using the outlier approach. Material and Methods: In this study, Box-Plot method was used to find limit values for total cholesterol. The method was preferred because it does not require excessive statistical knowledge, does not require the use of statistical tables, and is easy to interpret and apply. The data were obtained retrospectively by using the archival data of a total of 42,185 individuals, 24,782 females aged 1-93 years, 17,403 males aged 1-97 years, who were admitted to a university hospital outpatient clinic for any reason between January 1, 2023 and December 11, 2023, some of whom were diagnosed and some of whom were not diagnosed after admission. Results: According to the findings, the classification and limits of total serum cholesterol value for male adolescents were determined as ≤62 low, 63-169 acceptable, 170-199 borderline high, 200-228 high and ≥229 very high. For adult males, these limits are ≤55 low, 56-199 acceptable, 200-239 borderline high, 240-289 high, and ≥290 very high, respectively. For adolescent female were defined as ≤71 low, 72-169 acceptable, 170-199 borderline high, 200-225 high, and≥226 very high. For adult female, these limits are ≤72 low, 73-199 acceptable, 200-239 borderline high, 240-295 high, and≥296 very high, respectively. Conclusion: Although cut-off values are used in clinical evaluations, upper and lower reference values should also be considered. The reference limits obtained from the study for serum total cholesterol are clearer and more specific values that physicians can use for diagnosis.

Keywords: Serum total cholesterol; outlier analysis; reference limits; nonparametric method
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30.03.2014

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