Validation of the Friedewald formula for estimating low density lipoprotein cholesterol: the Korea National Health and Nutrition Examination Survey, 2009 to 2011
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Background/Aims: The aim of this study is to compare Friedewald-estimated and directly measured low density lipoprotein cholesterol (LDL-C) values and assess the concordance in guideline risk classification between the two methods. Methods: The data were derived from the 2009 to 2011 Korea National Health and Nutrition Examination Survey. We included subjects with triglyceride (TG) levels < 400 mg/dL. Analysis was done for 6,454 subjects who had all lipid panels— total cholesterol, directly measured LDL-C, high density lipoprotein cholesterol (HDL-C), and TG. Results: The subjects ranged in age from 10 to 87 years old. The mean age was 41.5 ± 17.3 years. For subjects with TG < 400 mg/dL, overall concordance in guideline risk classification was 79.1%. The Friedewald formula tended to underestimate LDL-C more at higher TG or lower HDL-C levels. Especially, the percent of subjects who were misclassified into a lower risk category was 31% when TG were 200 to 299 mg/dL; and 45.6% when TG were 300 to 399 mg/dL. A greater underestimation of LDL-C occurred at higher TG and lower Friedewald-estimated LDL-C levels. Of subjects with a Friedewald-estimated LDL-C < 70 mg/dL, 55.4% had a directly measured LDL-C ≥ 70 mg/dL when TG were 200 to 399 mg/dL. Conclusions: The Friedewald equation tends to underestimate LDL-C in highrisk subjects such as hypertriglyceridemia and hypo-HDL-cholesterolemia. For these individuals accurate assessment of LDL-C is crucial, and therefore additional evaluation is warranted.
Abstract
Background/Aims: The aim of this study is to compare Friedewald-estimated and directly measured low density lipoprotein cholesterol (LDL-C) values and assess the concordance in guideline risk classification between the two methods. Methods: The data were derived from the 2009 to 2011 Korea National Health and Nutrition Examination Survey. We included subjects with triglyceride (TG) levels < 400 mg/dL. Analysis was done for 6,454 subjects who had all lipid panels— total cholesterol, directly measured LDL-C, high density lipoprotein cholesterol (HDL-C), and TG. Results: The subjects ranged in age from 10 to 87 years old. The mean age was 41.5 ± 17.3 years. For subjects with TG < 400 mg/dL, overall concordance in guideline risk classification was 79.1%. The Friedewald formula tended to underestimate LDL-C more at higher TG or lower HDL-C levels. Especially, the percent of subjects who were misclassified into a lower risk category was 31% when TG were 200 to 299 mg/dL; and 45.6% when TG were 300 to 399 mg/dL. A greater underestimation of LDL-C occurred at higher TG and lower Friedewald-estimated LDL-C levels. Of subjects with a Friedewald-estimated LDL-C < 70 mg/dL, 55.4% had a directly measured LDL-C ≥ 70 mg/dL when TG were 200 to 399 mg/dL. Conclusions: The Friedewald equation tends to underestimate LDL-C in highrisk subjects such as hypertriglyceridemia and hypo-HDL-cholesterolemia. For these individuals accurate assessment of LDL-C is crucial, and therefore additional evaluation is warranted.
참고문헌 (22)
- Gaziano JM, "What's new with measuring cholesterol", JAMA, 310, pp.2043~2044 (2013)
- Steinberg D, "Thematic review series: the pathogenesis of atherosclerosis: an interpretive history of the cholesterol controversy, part III. Mechanistically defining the role of hyperlipidemia", J Lipid Res, 46, pp.2037~2051 (2005)
- Stein EA, "Measuring LDL cholesterol: for old and new calculations, is there an optimal formula?", Clin Chem, 60, pp.1466~1468 (2014)
- "2016 Health Screening Program Implementation Guide" (2011)[URL]
- "2013 National Health Screening Statistical Yearbook" (2011)[URL]
- Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge", Clin Chem, 18, pp.499~502 (1972)
- Jun KR, "Effects of total cholesterol and triglyceride on the percentage difference between the low-density lipoprotein cholesterol concentration measured directly and calculated using the Friedewald formula", Clin Chem Lab Med, 46, pp.371~375 (2008)
- Lindsey CC, "A clinical comparison of calculated versus direct measurement of low-density lipoprotein cholesterol level", Pharmacotherapy, 24, pp.167~172 (2004)
- Sibal L, "Friedewald equation underestimates low-density lipoprotein cholesterol at low concentrations in young people with and without type 1 diabetes", Diabet Med, 27, pp.37~45 (2010)
- Scharnagl H, "The Friedewald formula underestimates LDL cholesterol at low concentrations", Clin Chem Lab Med, 39, pp.426~431 (2001)
- Martin SS, "Friedewald-estimated versus directly measured low-density lipoprotein cholesterol and treatment implications", J Am Coll Cardiol, 62, pp.732~739 (2013)
- Committee for the Korean Guidelines for the Management of Dyslipidemia, "2015 Korean Guidelines for the Management of Dyslipidemia: Executive Summary (English Translation)", Korean Circulation Journal, 46(3), pp.275~306 (2016), 대한심장학회[DOI]
- 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, 106, pp.3143~3421 (2002)
- "Korea Health Statistics 2009: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3)" (2012)[URL]
- "Korea Health Statistics 2010: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1)" (2012)[URL]
- "Korea Health Statistics 2011: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-2)" (2012)[URL]
- 황유철, "Optimal Range of Triglyceride Values to Estimate Serum Low Density Lipoprotein Cholesterol Concentration in Korean Adults: the Korea National Health and Nutrition Examination Survey, 2009", Journal of Korean Medical Science, 27(12), pp.1530~1535 (2012), 대한의학회
- 허미나, "균질법에 의한 저밀도지단배콜레스테롤의 측정 및 Frieddwald 계산법과의 비교", Annals of Laboratory Medicine, 23(2), pp.104~108 (2003), 대한진단검사의학회
- Brinton EA, "Lipid abnormalities in the metabolic syndrome", Curr Diab Rep, 3, pp.65~72 (2003)
- Martin SS, "Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile", JAMA, 310, pp.2061~2068 (2013)
- Lee J, "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, 11, pp.e0148147~ (2016)
- "2013 Annual report on the cause of death statistics" (1996)[URL]