scholarly journals Treatment target re-classification of subjects comparing estimation of low-density lipoprotein cholesterol by the Friedewald equation and direct measurement of LDL-cholesterol

2018 ◽  
Vol 123 (2) ◽  
pp. 94-99
Author(s):  
Anders Larsson ◽  
Emil Hagström ◽  
Lennart Nilsson ◽  
Maria K. Svensson
Keyword(s):  
Direct Measurement ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Treatment Target ◽  
Friedewald Equation

scholarly journals Why Should We Measure Low-Density Lipoprotein Cholesterol Directly? Comparison of Low-Density Lipoprotein Cholesterol Assessment by Friedewald Estimation, and Direct Measurement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A305-A305
Author(s):  
Hofit Cohen
Keyword(s):  
Direct Measurement ◽  
Plasma Levels ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Wide Range ◽  
Friedewald Equation ◽  
The Difference

Abstract Intorduction: Plasma levels of low-density lipoprotein cholesterol (LDL-C) are an important biomarker for coronary artery disease. In clinical and research settings worldwide, levels LDL-C are often not measured and are estimated using the Friedewald equation (total cholesterol - HDL cholesterol - triglycerides)/5). Bias of either over or underestimation of LDL-C can be corrected by direct measurement of LDL-C. We assessed the precision of the Friedewald equation in a heterogonous patients population within a wide range of lipid levels. Methods: A sample of consecutive fasting lipid profiles was obtained from ambulatory and hospitalized patients at the Chaim Sheba Medical Center, Tel-Hashomer. LDL-C concentrations were directly measured (dir LDL-C) (Olympus, Ireland) and correspondingly calculated at by the Friedewald equation (calc LDL-C). Results: 32,245 samples were analyzed. In 93% of the samples, underestimation of plasma levels of LDL-C was observed using the Friedewald equation. In 11,054 patients (34.3%), the difference between dir LDL and calc LDL were over 10mg/dl. In 7,693 patients (23.8%), the difference between dir LDL and calc LDL were over 20mg/dl. The difference between dir LDL and calc LDL correlated with plasma TG levels, including TG levels within the normal range. The difference between cal LDL and dir LDL levels is inversely correlated to cholesterol plasma levels. Conclusions: Direct measurement of LDL-C is more precise than Friedewald’s formula and overcomes the inaccurateness, due to elevated TG levels or relatively low LDL-C levels, in the setting of a heterogeneous Israeli population. In the era of extremely low LDL-C treatment goals, our findings require consideration due to their clinical importance and direct measurement of plasma LDL-C should be implemented as underestimation of LDL levels may lead to inappropriate therapeutic decisions.

scholarly journals Comparing a novel equation for calculating low-density lipoprotein cholesterol with the Friedewald equation: A VOYAGER analysis

2019 ◽  
Vol 64 ◽  
pp. 24-29 ◽  
Author(s):  
Michael K. Palmer ◽  
Philip J. Barter ◽  
Pia Lundman ◽  
Stephen J. Nicholls ◽  
Peter P. Toth ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Friedewald Equation

scholarly journals Clinical Significance of Electronegative Low-Density Lipoprotein Cholesterol in Atherothrombosis

Biomedicines ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. 254 ◽  
Author(s):  
Chih-Sheng Chu ◽  
Shi Hui Law ◽  
David Lenzen ◽  
Yong-Hong Tan ◽  
Shih-Feng Weng ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Clinical Significance ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Exercise Stress ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Despite the numerous risk factors for atherosclerotic cardiovascular diseases (ASCVD), cumulative evidence shows that electronegative low-density lipoprotein (L5 LDL) cholesterol is a promising biomarker. Its toxicity may contribute to atherothrombotic events. Notably, plasma L5 LDL levels positively correlate with the increasing severity of cardiovascular diseases. In contrast, traditional markers such as LDL-cholesterol and triglyceride are the therapeutic goals in secondary prevention for ASCVD, but that is controversial in primary prevention for patients with low risk. In this review, we point out the clinical significance and pathophysiological mechanisms of L5 LDL, and the clinical applications of L5 LDL levels in ASCVD can be confidently addressed. Based on the previously defined cut-off value by receiver operating characteristic curve, the acceptable physiological range of L5 concentration is proposed to be below 1.7 mg/dL. When L5 LDL level surpass this threshold, clinically relevant ASCVD might be present, and further exams such as carotid intima-media thickness, pulse wave velocity, exercise stress test, or multidetector computed tomography are required. Notably, the ultimate goal of L5 LDL concentration is lower than 1.7 mg/dL. Instead, with L5 LDL greater than 1.7 mg/dL, lipid-lowering treatment may be required, including statin, ezetimibe or PCSK9 inhibitor, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Since L5 LDL could be a promising biomarker, we propose that a high throughput, clinically feasible methodology is urgently required not only for conducting a prospective, large population study but for developing therapeutics strategies to decrease L5 LDL in the blood.

scholarly journals Variability in cholesterol measurements: comparison of calculated and direct LDL cholesterol determinations

1996 ◽  
Vol 42 (5) ◽  
pp. 732-737 ◽  
Author(s):  
G Schectman ◽  
M Patsches ◽  
E A Sasse
Keyword(s):  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density Lipoprotein Cholesterol ◽  
Lipid Disorder ◽  
Total Variability ◽  
Friedewald Equation ◽  
C Value ◽  
Hypercholesterolemic Subjects

Abstract Calculated low-density lipoprotein cholesterol (LDL-C) concentrations determined from the Friedewald equation have a large intraindividual CV, in part because the calculation incorporates the variability of cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglyceride measurements. We studied whether a new assay that measures LDL-C directly will reduce this variability and reduce the need for averaging serial specimens. Four blood samples were obtained 1 week apart from 35 mildly hypercholesterolemic subjects and analyzed for total cholesterol, triglycerides, and HDL-C. LDL-C was calculated by the Friedewald equation, and was also measured directly with a commercially available direct LDL-C assay. The intraindividual CV for the direct and calculated LDL-C assays were similar [CV of direct LDL-C assay (mean +/- SE): 6.8 +/- 0.5% vs calculated LDL-C: 7.3 +/- 0.6%; difference 0.44%, 95% confidence interval: -0.7-1.5%]. For both assays, at least two blood tests were required from each subject to reduce total variability of LDL-C to less than or equal to 5%. We conclude that the direct LDL-C assay did not reduce the variability in LDL-C compared with the conventional LDL-C calculation. However, it may have a specific role in lipid disorder evaluation and (or) monitoring when triglycerides are increased or the LDL-C value alone is needed.

scholarly journals Validation of the Modified Friedewald’s Formula to Calculate Low-density Lipoprotein Cholesterol in Bangladeshi Population

2012 ◽  
Vol 30 (3) ◽  
pp. 141-144
Author(s):  
Mimi Parvin ◽  
Muhammad Saiedullah ◽  
Aminul Haque Khan ◽  
Muhammad Rezwanur Rahman ◽  
Md Saiful Islam
Keyword(s):  
Correlation Coefficient ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Bangladeshi Population ◽  
Modified Formula

Objective: A modification of Friedewald’s formula was proposed to calculate LDL cholesterol in Bangladeshi population up to serum triglyceride concentration of 1000 mg/dL. The aim of this study was to validate the modification of Friedewald’s formula in Bangladeshi population.Methods: Serum total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol concentrations were measured in specimens obtained form 314 adult Bangladeshi subjects selected conveniently. LDL cholesterol concentrations were also calculated by modified Friedewald’s formula and original Friedewald’s formula. Results were expressed as mean ± SD and calculated LDL cholesterol was compared with measured LDL cholesterol by two-tailed paired t test and Pearson’s correlation coefficient (r).Results: The mean ± SD of measured LDL cholesterol was 138.3 ± 54.58 mg/dL. LDL cholesterol calculated by modified Friedewald’s formula and original Friedewald’s formula were 135.9 ± 59.26 mg/dL (P>0.05) and 123.5 ± 65.75 mg/dL (P<0.001) respectively. Compared to measured LDL cholesterol, calculated LDL cholesterol were 2.47 mg/ dL and 17.20 mg/dL lower for modified formula and original formula respectively. The correlation coefficient (r) with measured LDL cholesterol was 0.8601 (P<0.0001) for LDL cholesterol calculated by the modified Friedewald’s formula and 0.8565 (P<0.0001) for the LDL cholesterol calculated by the original Friedewald’s formula.Conclusion: The study validates the modified Friedewald’s formula to calculate LDL cholesterol in Bangladeshi    population. DOI: http://dx.doi.org/10.3329/jbcps.v30i3.12463 J Bangladesh Coll Phys Surg 2012; 30: 141-144

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