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CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(01): 065-073
DOI: 10.1055/s-0041-1732496
Original Article

Comparison of Formula-Based Methods with Diverse TGL: VLDL-C Ratio for Calculating LDL-C in a Tertiary Care Hospital

Maneni V. P. Chowdary
1   Department of Biochemistry, KMCH Institute of Health Sciences & Research, Coimbatore, Tamil Nadu, India
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Abstract

Background The most popular Friedewald formula (FF) was tailored with a fixed factor of 5 for triglyceride-very low-density lipoprotein cholesterol (TGL:VLDL-C) ratio. Some of the subsequent studies on diverse population demonstrated modified FF with only altered TGL:VLDL-C ratio, comprising either a fixed or an adjustable factor. Hata and Nakajima as well as Puavilai et al proposed fixed factors of 4 and 6, respectively. Recently, Martin et al recommended an adjustable factor derived as N-strata-specific median TGL:VLDL-C ratio based on TGL and non-high-density lipoprotein cholesterol (non-HDL-C).

Aim This comparative retrospective study evaluates the efficacy of LDL-C formulae, varying only in TGL-VLDL-C ratio, using direct LDL-C assay as a reference method in a tertiary care hospital.

Materials and Methods A total of 1,747 patient records with lipid profile data were procured. Concordance analysis, absolute difference, and post hoc test were employed as analytical tools. The impact of total cholesterol (TChol), TGL, and HDL-C on formulae was also evaluated.

Results Overall, Martin equation had relatively the highest concordance, narrowest absolute difference, and minimal influence of TChol, TGL, and HDL-C. On the contrary, the Hata method revealed comparatively the lowest concordance, widest absolute difference, and high influence of TChol, TGL, and HDL-C. The remaining formula-based approaches, that is, FF and Puavilai calculation, executed mostly inconsistent intermittent features between Martin equation and Hata method.

Conclusion Relatively dominant and competitive analytical attributes of the Martin equation with an adjustable TGL:VLDL-C factor outweigh the remaining three formulae-based methods with fixed TGL:VLDL-C factor in Indian adults.

Keywords

total cholesterol - triglycerides - low-density lipoprotein cholesterol - high-density lipoproteins cholesterol - Very low-density lipoprotein cholesterol

Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
21. August 2021

© 2021. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel iii) final report. Circulation 2002; 106 (25) 3143-3421
    CrossrefPubMedGoogle Scholar
  • 2 Catapano AL, Graham I, De Backer G. et al. ESC Scientific Document Group. Group ESCSD. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J 2016; 37 (39) 2999-3058
    CrossrefPubMedGoogle Scholar
  • 3 Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18 (06) 499-502
    CrossrefPubMedGoogle Scholar
  • 4 Hata Y, Nakajima K. Application of Friedewald's LDL-cholesterol estimation formula to serum lipids in the Japanese population. Jpn Circ J 1986; 50 (12) 1191-1200
    CrossrefPubMedGoogle Scholar
  • 5 Puavilai W, Laorugpongse D, Deerochanawong C, Muthapongthavorn N, Srilert P. The accuracy in using modified Friedewald equation to calculate LDL from non-fast triglyceride: a pilot study. J Med Assoc Thai 2009; 92 (02) 182-187
    PubMedGoogle Scholar
  • 6 Martin SS, Blaha MJ, Elshazly MB. et al. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA 2013; 310 (19) 2061-2068
    CrossrefPubMedGoogle Scholar
  • 7 Fujimoto WY. Friedewald's LDL-cholesterol estimation formula in a Japanese American population. Jpn Circ J 1988; 52 (07) 604-606
    CrossrefPubMedGoogle Scholar
  • 8 Dansethakul P, Thapanathamchai L, Saichanma S, Worachartcheewan A, Pidetcha P. Determining a new formula for calculating low-density lipoprotein cholesterol: data mining approach. EXCLI J 2015; 14: 478-483
    PubMedGoogle Scholar
  • 9 Kang M, Kim J, Lee SY, Kim K, Yoon J, Ki H. Martins equation as the most suitable method for estimation of low-density lipoprotein cholesterol levels in Korean adults. Korean J Fam Med 2017; 38 (05) 263-269
    CrossrefPubMedGoogle Scholar
  • 10 Osegbe I, Ugonabo M, Chukwuka C, Meka I, Nwosu N. Comparison of calculated versus directly-measured low-density lipoprotein-cholesterol: an evaluation of ten formulas for an HIV-positive population in Sub-Saharan Africa. J Lab Physicians 2017; 9 (02) 111-115
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 11 Lee J, Jang S, Son H. Validation of the Martin method for estimating low-density lipoprotein cholesterol levels in Korean: findings from the Korea National Health and Nutritional Examination Survey, 2009–2011. PLoS One 2016; 11 (01) e0148147
    CrossrefPubMedGoogle Scholar
  • 12 Jialal I, Inn M, Siegel D, Devaraj S. Underestimation of low-density lipoprotein cholesterol with the Friedewald equation versus a direct homogenous low-density lipoprotein cholesterol assay. Lab Med 2017; 48 (03) 220-224
    CrossrefPubMedGoogle Scholar
  • 13 Anwar M, Khan DA, Khan FA. Comparison of Friedewald formula and modified Friedewald formula with direct homogeneous assay for low density lipoprotein cholesterol estimation. J Coll Physicians Surg Pak 2014; 24 (01) 8-12
    PubMedGoogle Scholar
  • 14 Wadhwa N, Krishnaswamy R. Comparison of LDL-cholesterol estimate using various formulae with directly measured LDL-cholesterol in Indian population. J Clin Diagn Res 2016; 10 (12) BC11-BC13
    PubMedGoogle Scholar
  • 15 Chowdary MVP, Sangeetha B. Comparison of Friedewald's formula and Martin's method with direct assay of serum LDL-cholesterol. Sch J App Med Sci 2018; 6 (03) 951-959
    Google Scholar
  • 16 Kaur NJ, Sharma A, Kaur RA. Current understanding in the measurement of low density lipoprotein cholesterol: A comparison of direct measurement by homogenous assays versus calculations. Int J Clin Biochem Res 2016; 3 (02) 162-168
    CrossrefGoogle Scholar
  • 17 Singh N, Pradeep Kumar BJ, Thimmaraju KV, Kumar KK, Sharma B, Kumar A. Anandaraja formula or Friedewald formula, which is better formula for calculating LDL-cholesterol in comparison with direct LDL-measurement by homogenous assay method. IJCMR 2017; 2 (01) 229-231
    Google Scholar
  • 18 Kapoor R, Chakraborty M, Singh N. A leap above Friedewald formula for calculation of low-density lipoprotein cholesterol. J Lab Physicians 2015; 7 (01) 11-16
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 19 Sridevi V, Vinit Anand, Mahendrappa SK. Comparison of Friedewald's and Anandraja's formula with direct estimation of low-density lipoprotein cholesterol in Shivamoga population. IAIM 2016; 3 (07) 120-131
    Google Scholar
  • 20 Nauck M, Warnick GR, Rifai N. Methods for measurement of LDL-cholesterol: a critical assessment of direct measurement by homogeneous assays versus calculation. Clin Chem 2002; 48 (02) 236-254
    CrossrefPubMedGoogle Scholar
  • 21 Rosa CdeO, Dos Santos CA, Leite JI, Caldas AP, Bressan J. Impact of nutrients and food components on dyslipidemias: what is the evidence?. Adv Nutr 2015; 6 (06) 703-711
    CrossrefPubMedGoogle Scholar
  • 22 Daoud E, Scheede-Bergdahl C, Bergdahl A. Effects of dietary macronutrients on plasma lipid levels and the consequence for cardiovascular disease. J Cardiovasc Dev Dis 2014; 1: 201-213
    CrossrefGoogle Scholar
  • 23 Giavarina D. Understanding Bland Altman analysis. Biochem Med (Zagreb) 2015; 25 (02) 141-151
    CrossrefPubMedGoogle Scholar
  • 24 Hanneman SK. Design, analysis, and interpretation of method-comparison studies. AACN Adv Crit Care 2008; 19 (02) 223-234
    PubMedGoogle Scholar