Evaluation of Four Different Equations for Calculating LDL-C with Eight Different Direct HDL-C Assays

Overview

Journal Clin Chim Acta

Specialty Biochemistry

Date 2013 May 1

PMID 23628525

Citations 16

Authors

Marcelo Jose Andrade Oliveira

Hendrick E van Deventer

Lorin M Bachmann

G Russell Warnick

Katsuyuki Nakajima

Masakasu Nakamura

Ikunosuke Sakurabayashi

Mary M Kimberly

Robert D Shamburek

William J Korzun

Gary L Myers

W Greg Miller

Alan T Remaley

Affiliations

Soon will be listed here.

Abstract

Background: Low-density lipoprotein cholesterol (LDL-C) is often calculated (cLDL-C) by the Friedewald equation, which requires high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Because there have been considerable changes in the measurement of HDL-C with the introduction of direct assays, several alternative equations have recently been proposed.

Methods: We compared 4 equations (Friedewald, Vujovic, Chen, and Anandaraja) for cLDL-C, using 8 different direct HDL-C (dHDL-C) methods. LDL-C values were calculated by the 4 equations and determined by the β quantification reference method procedure in 164 subjects.

Results: For normotriglyceridemic samples (TG<200mg/dl), between 6.2% and 24.8% of all results exceeded the total error goal of 12% for LDL-C, depending on the dHDL-C assay and cLDL-C equation used. Friedewald equation was found to be the optimum equation for most but not all dHDL-C assays, typically leading to less than 10% misclassification of cardiovascular risk based on LDL-C. Hypertriglyceridemic samples (>200mg/dl) showed a large cardiovascular risk misclassification rate (30%-50%) for all combinations of dHDL-C assays and cLDL-C equations.

Conclusion: The Friedewald equation showed the best performance for estimating LDL-C, but its accuracy varied considerably depending on the specific dHDL-C assay used. None of the cLDL-C equations performed adequately for hypertriglyceridemic samples.

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