Variability of lipids and apolipoproteins results across platforms may impact cardiovascular risk assessment

Abstract Objectives Lipid and apolipoprotein measurements are essential for cardiovascular risk assessment, particularly in patients with metabolic syndrome, type 2 diabetes, or borderline lipid values. Despite standardization efforts, analytical discrepancies between platforms may impact clinical decisions. This study aimed to evaluate the comparability of Cobas Integra and Abbott Alinity c for measuring total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and of Siemens BN ProSpec and Abbott Alinity c for measuring apolipoproteins A1 (ApoA1) and B (ApoB). Methods Paired plasma samples from 128 statin-treated adults with documented coronary heart disease were analyzed. Method comparison was performed using Passing-Bablok regression and Bland-Altman analysis. Results Good agreement was observed for TC, TG, and LDL-C, with minor biases and no significant deviation from linearity. HDL-C values measured on Alinity c were consistently lower than those from Cobas Integra (mean bias: −4.5 mg/dL). ApoA1 values were significantly higher on Alinity c than on BN ProSpec (mean bias: −0.49 g/L), suggesting a systematic discrepancy likely related to calibration differences. ApoB showed the highest level of concordance, with negligible bias (−0.09 g/L). Conclusions The Abbott Alinity c and Siemens BN ProSpec systems demonstrated good overall agreement in measuring lipids and apolipoproteins. However, notable differences in HDL-C and ApoA1 values may affect clinical interpretation, especially in patients with borderline results or when switching between analytical platforms.