Abstract
A modification of Friedewald's formula to estimate serum low-density lipoprotein cholesterol (LDLC) up to serum triglyceride (TG) level of 11.3 mmol/L in Bangladeshi population has recently been published. The aim of this study was to compare the modified formula with direct measurement of LDLC in Bangladeshi population in a different setting. One thousand and fifty two specimens from adult subjects were analyzed. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), LDLC and TG were measured by standard methods. The modified Friedewald's formula was applied to estimate LDL cholesterol concentration. Results were expressed as mean ± SD and calculated LDLC was compared with measured LDLC by two-tailed paired t test, Bland-Altman plot for absolute bias, Pearson's correlation coefficients of calculated LDLC with measured LDLC and Passing & Bablok regression equation of calculated LDLC against measured LDLC. The mean ± SD of measured LDLC was 2.98 ± 0.82 mmol/L. LDLC calculated by modified Friedewald's formula was 2.77 ± 0.86 mmol/L. The mean absolute bias was -0.20 ± 0.32 mmol/L, Pearson's correlation coefficient (r) was 0.9293 (P < 0.0001) and Passing & Bablok regression equation was y = - 0.3856+1.0597x for modified formula up to serum TG ≤ 11.3 mmol/L. Compared to original Friedewald's formula, performance of the modified Friedewald's formula was better up to serum TG ≤ 4.52 mmol/L. The study reveals that the modified Friedewald's formula may be used to calculate LDLC approximately in Bangladeshi population.
Highlights
Serum low-density lipoprotein cholesterol (LDLC) is an independent risk factor for the development of coronary heart disease[1]
According to Friedewald’s formula, LDLC can be calculated from three other lipid parameters, ie, serum total cholesterol (TC), serum triglycerides (TG) and serum high-density lipoprotein cholesterol (HDLC) by the formula LDLC=TC
The mean absolute bias of mf-LDLC compared to measured LDLC was –0.20±0.32 mmol/L for the mfLDLC - dLDLC
Summary
Serum low-density lipoprotein cholesterol (LDLC) is an independent risk factor for the development of coronary heart disease[1]. It is the recommended primary basis for treatment and correct classification in risk categories[2]. The reference method for the measurement of serum LDLC is the β-quantification[3]. Due to the technical difficulties associated with the reference method, new generation direct homogeneous methods have been developed and recommended for the measurement of LDLC as an alternative[4,5]. As a result Friedewald’s formula[6], the most widely used formula, is generally used for the estimation of LDLC by most of the laboratories in Bangladesh. According to Friedewald’s formula, LDLC can be calculated from three other lipid parameters, ie, serum total cholesterol (TC), serum triglycerides (TG) and serum high-density lipoprotein cholesterol (HDLC) by the formula LDLC=TC–
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