Abstract Background Treatments in recent years in cancer patients have been very favorable. However, some data suggest that dyslipidemia plays a role in carcinogenesis through the deregulation of the lipid signal, and this possibly leads to the development of cardiovascular diseases. A marker for the diagnosis and treatment of dyslipidemias is low density lipoproteins (LDL), and currently, the primary care level still calculates LDL due to the high costs of the direct method; Friedewald has been used since 1972, and in recent years, new equations have appeared such as Sampson and Martin - Hopkins (MH). These formulas use total cholesterol (TC), high-density lipoproteins (HDL), and triglycerides (TG). Objective was to compare the formulas for measuring LDL in cancer patients with hypertriglyceridemia. Methods It´s an observational, cross-sectional - and analytical study. The sample size was 880 lipid profiles processed in an automated dry chemistry analyzer between January and March 2023 at an Oncology Institute in Lima, Peru. The population was divided into several groups of triglyceride levels (<200 mg/dl, 200- 399 mg/dl, ≥ 400 mg/dl), and LDL was stratified according to ATP III to evaluate the classification of patients with respect to LDL formulas. The statistical analysis was performed by descriptive analysis of the categorical and numerical variables; The correlation was performed using Pearson, and a comparison of the LDL formulas was used by Bland Altman to determine the bias and percentage bias. To clinical relevance, it was compared with the biological variation of the Westgard table. A p-value <0.05 was considered significant, and the data were processed in MedCalc v20.027. Results The average age of the patients was 55.02 ± 13.92 years, and the frequency of female sex was 77.39% (n = 681). The average measured TC, HDL, and LDL were 208.95 ± 54.84 mg/dl, 41.53 ± 13.83 mg/dl, and 115.70 ±45.53 mg/dl, respectively, while the calculated average LDL in Friedewald was 120.40 ± 48.57, MH was 130.49 ± 44.15 mg/dl and Sampson was 125.97 ± 45.53 mg/dl. The correlations of measured versus calculated LDL were strong (r > 0.89) at different TG levels; Statistical (p<0.05) and clinical relevance was observed in the Friedewald formula when TG ≥ 400 mg/dl, while the MH and Sampson formulas presented clinical and significant relevance at all triglyceride levels. Patients with an LDL level between 130 and 159 mg/dl presented a more substantial classification error according to the Friedewald, MH, and Sampson formulas. Conclusions Friedewald formula presented a clinically acceptable bias up to 400 mg/dl, unlike the MH and Sampson formulas, which were affected by triglycerides ≥ 150 mg/dl.
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