Intuitive Modification of the Friedewald Formula for Calculation of LDL-Cholesterol
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Background: High LDL-cholesterol (LDL-C) is an established risk factor for cardiovascular disease and is considered an important therapeutic target. It can be measured directly or calculated from the results of other lipid tests. The Friedewald formula is the most widely used formula for calculating LDL-C. We modified the Friedewald formula for a more accurate and practical estimation of LDL-C. Methods: Datasets, including measured triglyceride, total cholesterol, HDL-cholesterol, and LDL-C concentrations were collected and assigned to derivation and validation sets. The datasets were further divided into five groups based on triglyceride concentrations. In the modified formula, LDL-C was defined as total cholesterol − HDL-cholesterol − (triglyceride/adjustment factor). For each group, the adjustment factor that minimized the difference between measured LDL-C and calculated LDL-C using modified formula was obtained. For validation, measured LDL-C and LDL-C calculated using the modified formula (LDL-CM), Friedewald formula (LDL-CF), Martin-Hopkins formula (LDL-CMa), and Sampson formula (LDL-CS) were compared. Results: In the derivation set, the adjustment factors were 4.7, 5.9, 6.3, and 6.4 for the groups with triglyceride concentrations <100, 101–200, 201–300, and >300 mg/dL, respectively. In the validation set, the coefficient of determination (R2) between measured and calculated LDL-C was higher for LDL-CM than for LDL-CF (R2=0.9330 vs. 0.9206). The agreement according to the National Cholesterol Education Program Adult Treatment Panel III classification of LDL-C was 86.36%, 86.08%, 86.82%, and 86.15% for LDL-CM, LDL-CF, LDL-CMa, and LDL-CS, respectively. Conclusions: We proposed a practical, improved LDL-C calculation formula by applying different factors depending on the triglyceride concentration.
Abstract
Background: High LDL-cholesterol (LDL-C) is an established risk factor for cardiovascular disease and is considered an important therapeutic target. It can be measured directly or calculated from the results of other lipid tests. The Friedewald formula is the most widely used formula for calculating LDL-C. We modified the Friedewald formula for a more accurate and practical estimation of LDL-C. Methods: Datasets, including measured triglyceride, total cholesterol, HDL-cholesterol, and LDL-C concentrations were collected and assigned to derivation and validation sets. The datasets were further divided into five groups based on triglyceride concentrations. In the modified formula, LDL-C was defined as total cholesterol − HDL-cholesterol − (triglyceride/adjustment factor). For each group, the adjustment factor that minimized the difference between measured LDL-C and calculated LDL-C using modified formula was obtained. For validation, measured LDL-C and LDL-C calculated using the modified formula (LDL-CM), Friedewald formula (LDL-CF), Martin-Hopkins formula (LDL-CMa), and Sampson formula (LDL-CS) were compared. Results: In the derivation set, the adjustment factors were 4.7, 5.9, 6.3, and 6.4 for the groups with triglyceride concentrations <100, 101–200, 201–300, and >300 mg/dL, respectively. In the validation set, the coefficient of determination (R2) between measured and calculated LDL-C was higher for LDL-CM than for LDL-CF (R2=0.9330 vs. 0.9206). The agreement according to the National Cholesterol Education Program Adult Treatment Panel III classification of LDL-C was 86.36%, 86.08%, 86.82%, and 86.15% for LDL-CM, LDL-CF, LDL-CMa, and LDL-CS, respectively. Conclusions: We proposed a practical, improved LDL-C calculation formula by applying different factors depending on the triglyceride concentration.
참고문헌 (29)
- Grundy SM, "2018 AHA", ACC, AAPA, pp.ABC, ACPM[DOI]
- Hyun Suk Yang, "HDL Subclass Analysis in Predicting Metabolic Syndrome in Koreans With High HDL Cholesterol Levels", Annals of Laboratory Medicine, 40(4), pp.297~305 (2020), 대한진단검사의학회[DOI]
- Yang Hyun Suk, "Sex-Specific U-Shaped Relationships Between High-Density Lipoprotein Cholesterol Levels and 10-year Major Adverse Cardiovascular Events: A Nationwide Cohort Study of 5.7 Million South Koreans", Annals of Laboratory Medicine, 42(4), pp.415~427 (2022), 대한진단검사의학회[DOI]
- Berliner JA, "Atherosclerosis: basic mechanisms. Oxidation, inflammation, and genetics", Circulation, 91, pp.2488~2496 (1995)
- Navab M, "Pathogenesis of atherosclerosis", Am J Cardiol, 76, pp.18C~23C (1995)
- Cholesterol Treatment Trialists’ (CTT) Collaboration, "Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials", Lancet, 376, pp.1670~1681 (2010)
- Ference BA, "Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease : a Mendelian randomization analysis", J Am Coll Cardiol, 60, pp.2631~2639 (2012)
- Ference BA, "Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel", Eur Heart J, 38, pp.2459~2472 (2017)
- Baigent C, "Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins", Lancet, 366, pp.1267~1278 (2005)
- Mach F, "ESC", EAS Guidelines for the management of dyslipidaemias : lipid modification to reduce cardiovascular risk, 2020, pp.41, 111~188
- Rifai N, "Handbook of Lipoprotein Testing" (2001), AACC Press
- Nauck M, "Methods for measurement of LDL-cholesterol : a Critical assessment of direct measurement by homogeneous assays versus calculation", Clin Chem, 48, pp.236~254 (2002)
- Türkalp I, "Analytical performance of a direct assay for LDL-cholesterol : a comparative assessment versus Friedewald’s formula", Anadolu Kardiyol Derg, 5, pp.13~17 (2005)
- Miller WG, "Seven direct methods for measuring HDL and LDL cholesterol compared with ultracentrifugation reference measurement procedures", Clin Chem, 56, pp.977~986 (2010)
- "Educational Discussion: Lipids, 2018 Accuracy-Based Lipids (ABL)"[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)
- Anandaraja S, "Low-density lipoprotein cholesterol estimation by a new formula in Indian population", Int J Cardiol, 102, pp.117~120 (2005)
- Hattori Y, "Development of approximate formula for LDL-chol, LDL-apo B and LDL-chol", LDL-apo B as indices of hyperapobetalipoproteinemia and small dense LDL, 1998, pp.138, 289~299
- Puavilai W, "The accuracy in using modified Friedewald equation to calculate LDL from non-fast triglyceride : a pilot study", J Med Assoc Thai, 92, pp.182~187 (2009)
- Hata Y, "Application of Friedewald’s LDL-cholesterol estimation formula to serum lipids in the Japanese population", Jpn Circ J, 50, pp.1191~1200 (1986)
- 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)
- Sampson M, "A new equation for calculation of low-density lipoprotein cholesterol in patients with normolipidemia and", or hypertriglyceridemia, 2020, pp.5, 540~548
- Arranz-Peña ML, "Comparison of two homogeneous assays with a precipitation method and an ultracentrifugation method for the measurement of HDL-cholesterol", Clin Chem, 44, pp.2499~2505 (1998)
- Iwasaki Y, "Improved specificity of a new homogeneous assay for LDL-cholesterol in serum with abnormal lipoproteins", Clin Chem, 52, pp.886~888 (2006)
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive summary of the 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)", JAMA, 285, pp.2486~2497 (2001)
- Martin SS, "Friedewald-estimated versus directly measured low-density lipoprotein cholesterol and treatment implications", J Am Coll Cardiol, 62, pp.732~739 (2013)
- Myers GL, "A reference method laboratory network for cholesterol : a model for standardization and improvement of clinical laboratory measurements", Clin Chem, 46, pp.1762~1772 (2000)
- Beckman Coulter, "LDL-cholesterol calibrator Instructions for Use BLODC0012.04", ~ (2016)
- Rossouw HM, "Comparability of 11 different equations for estimating LDL cholesterol on different analysers", Clin Chem Lab Med, 59, pp.1930~1943 (2021)