저밀도지단백 콜레스테롤의 실측치와 계산치 비교분석
The comparison analysis between measured and estimated LDL-cholesterol
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연구배경 : 저밀도지단백 콜레스테롤은 고지혈증 치료의 중요한 지표이나, 직접 측정보다는 공식을 이용한 간접치가 많이 쓰이고 있다. 본 연구는 이의 실측치와 공식에 의한 계산치를 비교하여 공식이 실제 어떤 경우에 얼마나 적합한지 살펴보았다. 방 법 : 2001년 한해동안 병원의 검사종합건진 대상자들의 자료로 분석하였다. 실측치와 비교하기 위해 고전적인 Friedewald 공식의 중성지방(TG)/5 대신 TG/4, TG/4.5, TG/5.5, TG/6, TG/7, TG/8 각각을 적용하여 비교분석하였고, 중성지방 및 총콜레스테롤 수치에 따른 비교분석도 하였다. 결 과 : 실측치와 계산치 사이에는 높은 상관관계가 있었으며, TG/6를 사용한 계산식에서 가장 높았다(r=0.938). 이는 특히 TG가 100-249mg/dl일 때 실측치와 비교해서 가장 높은 일치율을 보였다(72-82%). 하지만 TG가 높아질수록 일치율이 떨어졌으며 TG가 400mg/dl 이상에서는 그 비율이 44%이하까지 감소했다. 총콜레스테롤이 200-239mg/dl인 경우에는 TG에 무관하게 TG/6로 계산된 경우에 가장 일치율이 높았다. 결 론 : 전반적으로 공식에서 TG/5 대신 TG/6를 사용했을 때 더 우수한 결과를 얻었다. 총콜레스테롤 역시 공식을 이용할 때 중요한 변수 중의 하나임을 알 수 있었다.
Abstract
Background : Low-Density lipoprotein cholesterol(LDLC) is the main marker in hyperlipidemia. However, LDLC is usually estimated by the Friedewald equation rather than directly measured. So, we assess the validity of the formula by comparing each value. Methods : The data were collected from 38,932 persons who took the periodic health examinations done at one university hospital in 2001. We compared the measured serum LDLC concentrations with calculated values by using the several terms of triglycerides(TG) (TG/4, TG/4.5, TG/5, TG/5.5, TG/6, TG/7, and TG/8). We also compared them by using the several groups of TG and total cholesterol level. Results : There is the highest correlation when we using the term TG/6 (r=0.938). Especially For TG levels 100-249mg/dl, TG/6 is the most closely matching term and gave the smallest mean percent errors. The greater the TG levels were, however, the more estimation errors were occurred. Above 400mg/dl of TG, the correspondency was decreased to below 44%. Using TG/6 was also adequate independently when the total cholesterol level was 200-239mg/dl. Conclusions : Generalizing the results, It seems more valid when we use TG/6 in the formula. And total cholesterol level is another important variable using this formula.
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