Martin's Formula As the Most Suitable Method for Estimation of Low-Density Lipoprotein Cholesterol in Indian Population

Fatima Farheen; Sudha Ambiger; Kamarudin Jaalam; Shivalingappa Javali

doi:10.1055/s-0043-1768951

Journal of Laboratory Physicians, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(04): 545-551
DOI: 10.1055/s-0043-1768951

Original Article

Martin's Formula As the Most Suitable Method for Estimation of Low-Density Lipoprotein Cholesterol in Indian Population

Fatima Farheen

¹Department of Chemical Pathology, USM KLE International Medical Programme, Belgaum, Karnataka, India

,

Sudha Ambiger

²Department of Biochemistry, KLE Academy of Higher Education and Research (KAHER), J.N. Medical College, Belagavi, Karnataka

,

Kamarudin Jaalam

³Department of Anaesthesia and Critical Care Medicine, School of Medical Science, PPSP USM Kubang Kerian, Malaysia, and Deputy Dean, USM KLE International Medical Programme, Belgaum, India

,

Shivalingappa Javali

⁴Department of Community Medicine, USM KLE International Medical Programme, Belgaum, Karnataka, India

› Institutsangaben

Abstract

Background Because of cost effectiveness, most of the laboratories in India estimate low-density lipoprotein cholesterol (LDL-C) levels with the Friedewald's formula. There were many shortcomings of the Friedewald's formula. Recently, Martin and colleagues have derived a new formula for calculating LDL-C. The present study was undertaken to calculate LDL-C using various formulae (Friedewald's formula, Anandaraja's formula, and Martin's formula) and to compare directly measured LDL-C (D-LDL-C) with calculated LDL-C at various ranges of triglyceride (TG) concentration.

Materials and Methods The present study compared LDL-C measured by Martin's formula, Friedewald's formula, and Anandaraja's formula with D-LDL-C in 280 outpatient fasting samples between the age groups of 18 and 50 years. Depending on the TG values, study samples were divided into four groups. Group 1: less than 200 mg/dL; Group 2: 200 to 300 mg/dL; Group 3: 300 to 400 mg/dL; and Group 4: more than 400 mg/dL.

Results Martin's formula shows highest correlation with r-value of 0.9979 compared with Friedewald's (0.9857) and Anandaraja's (0.9683) r-values. The mean difference was least for Martin's formula (0.31 ± 3.53) compared with other formulae. Among all the groups, percentage of error was least for Martin's formula (0.23%). Martin's LDL-C shows highest concordance (90.90%) compared with Friedewald's (79.60%) and Anandaraja's formulae (82.90%).

Conclusion Among all the groups, Martin's formula shows highest correlation, least percentage of error, highest concordance, and least mean differences. At all TG levels, Martin's formula is the best formula compared with the Friedewald's formula and Anandaraja's formula.

Keywords

LDL-C - Martin's formula - Anandaraja's formula - Friedewald's formula

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References
1 Talwalkar PG, Sreenivas CG, Gulati A, Baxi H. Journey in guidelines for lipid management: from adult treatment panel (ATP)-I to ATP-III and what to expect in ATP-IV. Indian J Endocrinol Metab 2013; 17 (04) 628-635
2 Badrakiya KM, Shah AD, Makadia MG. Comparison of LDL-cholesterol estimated by direct method and by calculation. IJBAR 2016; 7 (08) 353-358
3 Schaefer EJ, Otokozawa S, Ai M. Limitations of direct methods and the reference method for measuring HDL and LDL cholesterol. Clin Chem 2011; 57 (07) 1081-1083 , author reply 1083
4 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
5 Anandaraja S, Narang R, Godeswar R, Laksmy R, Talwar KK. Low-density lipoprotein cholesterol estimation by a new formula in Indian population. Int J Cardiol 2005; 102 (01) 117-120
6 Kang M, Kim J, Lee SY, Kim K, Yoon J, Ki H. Martin's 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
7 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
8 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
9 Sahu S, Chawla R, Uppal B. Comparison of two methods of estimation of low density lipoprotein cholesterol, the direct versus Friedewald estimation. Indian J Clin Biochem 2005; 20 (02) 54-61
10 Molavi F, Namazi N, Asadi M. et al. Comparison common equations for LDL-C calculation with direct assay and developing a novel formula in Iranian children and adolescents: the CASPIAN V study. Lipids Health Dis 2020; 19 (01) 129
11 Kamal AH, Hossain M, Chowdhury S, Mahmud NU. A comparison of calculated with direct measurement of low density lipoprotein cholesterol level. JCMCTA 2009; 20: 19-23
12 Agrawal M, Spencer HJ, Faas FH. Method of LDL cholesterol measurement influences classification of LDL cholesterol treatment goals: clinical research study. J Investig Med 2010; 58 (08) 945-949
13 Tremblay AJ, Morrissette H, Gagné JM, Bergeron J, Gagné C, Couture P. Validation of the Friedewald formula for the determination of low-density lipoprotein cholesterol compared with beta-quantification in a large population. Clin Biochem 2004; 37 (09) 785-790
14 Mora S, Rifai N, Buring JE, Ridker PM. Comparison of LDL cholesterol concentrations by Friedewald calculation and direct measurement in relation to cardiovascular events in 27,331 women. Clin Chem 2009; 55 (05) 888-894
15 Gazi IF, Elisaf M. LDL-cholesterol calculation formulas in patients with or without the metabolic syndrome. Int J Cardiol 2007; 119 (03) 414-415
16 Gupta S, Verma M, Singh K. Does LDL-C estimation using Anandaraja's formula give a better agreement with direct LDL-C estimation than the Friedewald's formula?. Indian J Clin Biochem 2012; 27 (02) 127-133
17 Kamezaki F, Sonoda S, Nakata S, Otsuji Y. A direct measurement for LDL-cholesterol increases hypercholesterolemia prevalence: comparison with Friedewald calculation. J UOEH 2010; 32 (03) 211-220
18 Sudha K, Prabhu A, Kiran AM, Marathe A, Hegde A. Validation of the Friedewald formula in type II diabetes mellitus: an Indian perspective study. Int J Biol Adv Res 2015; 6: 103-106
19 Krishnaveni P, Gowda VM. Assessing the validity of Friedewald's formula and Anandraja's formula for serum LDL-cholesterol calculation. J Clin Diagn Res 2015; 9 (12) BC01-BC04
20 Miller WG, Myers GL, Sakurabayashi I. et al. Seven direct methods for measuring HDL and LDL cholesterol compared with ultracentrifugation reference measurement procedures. Clin Chem 2010; 56 (06) 977-986
21 Nakanishi N, Matsuo Y, Yoneka H, Nakamura K, Suzuki K, Tatara K. Validity of the conventional indirect methods including Friedewald method for determining serum low density lipoprotein cholesterol level: comparison with the direct homogenous enzymatic analysis. J Occup Health 2002; 42: 130-137
22 Lee J, Jang S, Son H. Validation of the Martin method for estimating low-density lipoprotein cholesterol levels in Korean adults: findings from the Korea National Health and Nutrition Examination Survey, 2009–2011. PLoS One 2016; 11 (01) e0148147