Friedewald Formula Research Articles

The effect of Oleoylethanolamide supplementation on lipid profile, fasting blood sugar and dietary habits in obese people: a randomized double-blind placebo-control trial.

Abnormalities in biochemical parameters and changes in eating habits are considered complications of obesity. Oleoylethanolamide (OEA), an endocannabinoid-like compound, has been shown to have protective effects on many metabolic disorders. Given this evidence, the present study aimed to assess the effects of OEA on lipid profile parameters, fasting blood sugar (FBS), and dietary habits in healthy obese people. In this randomized, double-blind, placebo-controlled clinical trial, which was carried out in 2016 in Tabriz, Iran, 60 obese people were enrolled in the study based on inclusion criteria. The intervention group consumed 125mg of OEA capsules, and the placebo group received the same amount of starch twice for 8 weeks. Blood samples (5 mL) were taken at baseline and the end of the study in a fasting state. Serum concentrations of FBS, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) were measured by enzymatic methods using commercial kits. The low-density lipoprotein cholesterol (LDL-C) concentration was obtained using the Friede-Wald formula. To assess dietary habits, a food frequency questionnaire (147 items) was used at baseline and the end of the study. A value less than < 0.05 was considered to indicate statistical significance. The TG concentration decreased significantly in the intervention group (mean (SD): 166.29 (70.01) mg/dL to 142.22 (48.05) mg/dL, p = 0.047). Changes in the placebo group were not significant (p > 0.05). After adjusting for baseline values and demographic characteristics, the difference in TG between groups remained significant (p = 0.044). Changes in other biochemical parameters were not significant. There was no significant difference between or within groups in terms of food groups. OEA, as a complementary agent, plays a protective role in TG regulation. However, future studies with longer durations are needed to explore the impact of OEA on regulating dietary habits and to identify the mechanisms related to metabolic abnormalities in obese people. The study was registered in the Iranian Registry of Clinical Trials (IRCT) center as IRCT201607132017N30 with URL. www.IRCT.IR in date 03/10/2016.

A-214 Evaluate LDL-C using NIH equation 2, Friedewald equation, and direct homogeneous measurement

Abstract Background It is essential to accurately assess Low-density lipoprotein cholesterol (LDL-C) levels, a key marker for cardiovascular disease often used for treatment recommendations. The Friedewald equation has been used for many years to calculate plasma LDL-C levels, but it has limitations. Therefore, before implementing the NIH equation, we compared LDL-C results from NIH Equation 2 to the Friedewald formula and then to Atellica direct homogeneous assay LDL-C results. Methods A retrospective study of 1200 randomly selected patients out of 53,258 data points pulled from the laboratory information (LIS) system between November 2021 and October 2023. The study evaluated triglycerides, LDL-C, total cholesterol, and HDL-C measurements. The LDL-C calculated using NIH equation 2 has been set in the LIS as a non-reportable test component since November 1, 2021. The results obtained from NIH equation 2 and Friedewald equation were compared. LDL-C levels were measured using an Atellica direct homogeneous assay for an additional 75 specimens. Deming regression analysis compared measured and calculated LDL-C using both formulae. Results The LDL-C calculated using the Friedewald equation has a mean of 106.1 mg/dL and SD 40.1 mg/dL, while the NIH equation has a mean of 108.5 mg/dL and SD 39.9 mg/dL. The average difference between both equations is 2.5 mg/dL, and there is a significant difference between both calculations using paired t-tests (p-value&amp;lt;0.0001). We first compared the calculated LDL-C derived from the Friedewald formula to the NIH equation 2. The regression analysis equation for the Friedewald formula was y = -2.7 + 1.001 X (r = 0.99). When the Triglyceride values &amp;lt;150 mg/dL (N=879), the average difference is 1.3, and the regression equation is -0.45+1.01X(r=0.99). However, when the Triglyceride value &amp;gt;= 150 mg/dL (N=321), the average bias is 5.4 mg/dL, and the regression equation is -11.2+1.05X(r=0.99). The Friedewald formula was compared to the measured LDL-C in 75 specimens; the regression analysis for the Friedewald formula was y = -19.6 + 1.06 X (r = 0.91, p-value &amp;lt;0.0001). The 75 measured LDL-C results were also compared with the NIH formula. The regression analysis of NIH LDL-C with measured LDL-C was y = -5.6 + 0.981 x (r = 0.90, p-value = 0.0002). Both formulae showed a linear relationship against measured LDL-C. The NIH formula outperformed the Friedewald formula; bias difference -7.8(-6.8%) compared to the Friedwald equation bias -12.9(-12.0%). If the NIH equation had been used during this period, an additional 1,116 patients would have had LDL-C results. This is because the Friedewald equation should not be used if the triglyceride value is above 400 mg/dL. Out of the additional patients, 513 (46%) had a high LDL (&amp;gt;100 mg/dL). Conclusions The NIH formula performed better than the Friedewald formula, with a less negative bias when both calculations were compared to direct homogenous measurement. The average difference between the two formulas showed the lowest value when triglyceride &amp;lt; 150 mg/dL. Moving to NIH equation 2 will benefit our population as we had 2% of our patients in the past two years have triglyceride &amp;gt;400 mg/dL.

A-212 Comparison of formulas for measuring LDL in cancer patients with hypertriglyceridemia

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 (&amp;lt;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 &amp;lt;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 &amp;gt; 0.89) at different TG levels; Statistical (p&amp;lt;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.

Exogenous Insulin Effect on the Initiation of Breast Cancer in Type 2 Diabetes Mellitus Patients

Background: Growing evidence has indicated that women with type 2 diabetes mellitus are at an increased risk of developing breast cancer. However, as a major adjuvant treatment, the influence of hormone therapy such as exogenous insulin on type 2 diabetes mellitus in primary breast-cancer remains controversial. Objective: To explore the relationship between different types of hypoglycemic medications for diabetes and the factors that may contribute to the initiation of breast cancer. Methods: The study included 80 blood samples taken from 80 females recruited from Ibn Al-Bitar Center for Cardiac Surgery Hospital in Baghdad, Iraq, between November 2022 and February 2023. They were within the age range of 40 to 70 years. They were divided into three groups according to the treatment strategy and duration of disease as follows: Group 1: (20) patients who take insulin only, Group 2: (20) patients who take metformin with insulin, and G 3: (40) patients on metformin only for less than one year. An enzymatic oxidation technique was used to test the following biochemical parameters for all research groups: Total cholesterol, triglycerides, fasting blood glucose, and high-density lipoprotein cholesterol. Using the Friedewald formula, the very low-density lipoprotein cholesterol and low-density lipoprotein cholesterol were determined. Using an enzymatic process, Insulin levels and Insulin like growth factor-1(IGF-1), Estrogen receptor alpha (ERα) levels, and breast cancer susceptibility protein 1 (BRCA1) were measured with an enzyme-linked immunosorbent assay (ELISA). Glycated hemoglobin (HbA1c) level was measured with a sandwich immunodetection method. Finally, The Homeostasis Model Assessment for insulin resistance (HOMA-IR) was calculated according to the specific formula. Results: The values for HbA1C%, FBS, and lipid profile showed non-significant differences when compared between study groups. While BRCA-1, estrogen receptor alpha (ERα), insulin, insulin growth factor IGF-1, and HOMA IR All showed significant differences among all groups. Conclusion: Taking metformin only for less than one year seemed to contribute to higher levels of BRCA-1.

Is lipoprotein(a) measurement important for cardiovascular risk stratification in children and adolescents?

BackgroundElevated lipoprotein (Lp(a)) levels are associated with increased risk of atherosclerotic processes and cardiovascular events in adults. The amount of Lp(a) is mainly genetically determined. Therefore, it is important to identify individuals with elevated Lp(a) as early as possible, particularly if other cardiovascular risk factors are present. The purpose of the study was to investigate whether, in a population of children and adolescents already followed for the presence of one or more cardiovascular risk factors (elevated blood pressure (BP), and/or excess body weight, and/or dyslipidemia), the measurement of Lp(a) can be useful for better stratifying their risk profile.MethodsIn a sample of 195 children and adolescents, height, body weight, waist circumference and systolic (SBP) and diastolic (DBP) BP were measured. Body Mass Index (BMI) and SBP and DBP z-scores were calculated. Plasma Lp(a), total cholesterol, high-density lipoprotein (HDL), triglycerides, glucose, insulin, uric acid and creatinine were assessed. Low-density lipoprotein (LDL) cholesterol was calculated with the Friedewald formula. High Lp(a) was defined as ≥ 75 nmol/L and high LDL cholesterol as ≥ 3.37 mmol/L.ResultsOur sample of children and adolescents (54.4% males, mean age 11.5 years) had median LDL cholesterol and Lp(a) values equal to 2.54 (interquartile range, IQR: 2.07–3.06) mmol/L and 22 (IQR: 7.8–68.6) nmol/L respectively. 13.8% of children had LDL cholesterol ≥ 3.37 mmol/L and 22.6 Lp(a) values ≥ 75 nmol/L. Lp(a) values were higher in children of normal weight than in those with excess weight (p = 0.007), but the difference disappeared if normal weight children referred for dyslipidemia only were excluded from the analysis (p = 0.210). 69.4% of children had normal Lp(a) and LDL cholesterol values and only 6.2% showed both elevated Lp(a) and LDL cholesterol levels. However, 16.6% of the sample, despite having normal LDL cholesterol, had elevated Lp(a) values. Multivariable analyses showed a significant association of LDL cholesterol both with Lp(a) values, and with the presence of elevated Lp(a) levels. For each mmol/L increase in LDL cholesterol the risk of having an elevated Lp(a) value increased by 73%. There was an inverse correlation between BMI z-score and Lp(a). Neither BP z-scores, nor other biochemical parameters were associated with Lp(a).ConclusionsIn our population more than one out of five children had elevated Lp(a) values, and in about 17% of children elevated Lp(a) values were present in the absence of increased LDL cholesterol. Our results suggest that Lp(a) measurement can be useful to better define the cardiovascular risk profile in children and adolescents already followed for the presence of other cardiovascular risk factors such as elevated BP, excess body weight and high LDL cholesterol.

Comparison between Friedewald's and Sampson's formulas in the estimation of high levels of measured LDL-cholesterol in youth with obesity

Background and aimTo assess the performance of Friedewald's and Sampson's formulas in relation to high or borderline-high levels of measured LDL-Cholesterol (LDL-C) in youths with overweight/obesity (OW/OB). Methods and resultsA cross-sectional study was performed in 1694 youths (age 5–17 years) with OW/OB observed in Italian centers of Messina (group 1) and Naples (group 2). LDL-C levels were both measured and calculated using Friedewald's (LDL-CF) and Sampson's (LDL-CS) formulas. The two groups were similar for sex, age, BMI, BMI Z-score, and measured LDL-C. Levels of LDL-CF and LDL-CS were higher in group 1 than group 2. In the overall sample, 9.9 % youths had measured LDL-C ≥130 mg/dL and 27.8 % ≥ 110 mg/dL, without differences between centers. The two formulas showed comparable high sensitivity and specificity in relation to levels of measured LDL-C ≥130 mg/dL or ≥110 mg/dL. However, LDL-CF showed a higher positive predictive value than LDL-CS. ConclusionsBoth formulas estimate with high accuracy measured LDL-C levels in youths with OW/OB. Therefore, calculated LDL-C can be a useful tool for universal screening when direct LDL-C measurement is not available. The Friedewald's formula is more feasible in clinical practice for simplicity of calculation.

Integration of Primary Preventive Care of Cardiovascular Disease in a Retroviral Clinic in an adult retroviral clinic in Ibadan: A retrospective study.

A consequence of improved survival of people living with human immunodeficiency virus (HIV) (PLHIV) is an aging population with an increased risk of developing atherosclerotic cardiovascular diseases (ASCVDs). International guidelines recommend primary preventive strategies which should be integrated into routine care of PLHIV. This study audited the ASCVD preventive practices offered to PLHIV at the adult antiretroviral clinic in Ibadan. This was a retrospective review of clinical records of all persons who were recruited into the antiretroviral therapy clinic between January 1 and December 31, 2018. Cardiovascular disease (CVD) preventive practices were audited against recommendations of the American Heart Association for PLHIV. The records of 568 persons with a mean (standard deviation) age of 39.95 (11.77) years were reviewed. There were 365 (64.26%) females and 203 (35.74%) males. Only 364 (64.08%) patients had the required parameters for the calculation of the low-density lipoprotein cholesterol (LDL-C) by the Friedewald formula. Ten-year ASCVD risk was not calculated for any of the patients during their clinic visits. Thirty-seven (6.51%) patients had either an LDL-C ≥4.91 mmol/L or an age between 40 and 75 years with diabetes mellitus or ASCVD risk score (when calculated) ≥ 7.5%. Only one of these persons was referred for specialist care of lifestyle modification. Fifty (8.80%) persons had an eGFR <60 mLs/min, but only 11 (1.94%) were referred for nephrology care. The integration of primary preventive cardiovascular practices into routine care for PLHIV is suboptimal. A revision of the recommendations of the Nigerian National Guidelines for HIV may be a useful first step addressing this.

Comparison of ten formulae for calculating low-density lipoprotein cholesterol with direct low-density lipoprotein cholesterol measurement

ABSTRACT Background: Accurate lipid profile assessment, mainly low-density lipoprotein cholesterol (LDL-C) measurement, is crucial for diagnosing and managing cardiovascular disease (CVD). The widely used Friedewald formula for LDL-C calculation has limitations, prompting the exploration of alternative equations. Aims: This study aims to compare ten LDL-C calculation formulas with direct measurement among study participants attending a tertiary care centre. Materials and Methods: Conducted from September 2021 to July 2022 at a tertiary healthcare centre in India, the study involved 114 participants aged 18 years or older. The exclusion criteria were high-serum triglyceride (TG) levels, renal failure, diabetes, liver diseases or unwillingness to participate. Blood samples were analysed for total cholesterol, TG, high-density lipoprotein cholesterol and LDL-C. The very-low-density lipoprotein cholesterol level was calculated. The LDL-C formulas evaluated were Friedewald, Anandaraja, De Cordova, Vujovic, Ahmadi, Puavillai, Chen, Hattori, Martin–Hopkin and Sampson. Results: Vujovic’s formula showed a negligible mean difference and strong correlation (r = 0.916, P &lt; 0.001) with direct LDL-C estimation across TG concentrations. Sampson’s formula performed best for TG &lt;150 mg/dL, whereas Vujovic’s formula excelled for 151–399 mg/dL TG concentrations. All formulas were highly correlated with direct LDL-C levels (P &lt; 0.001). Bland–Altman analysis indicated Vujovic’s formula as the closest match to direct measurement, with a mean bias of −1.42 ± 20.59 mg/dL. Conclusion: Vujovic’s formula demonstrated the slightest difference and strong correlation with direct LDL-C measurement, outperforming other formulas. This finding enhances the accuracy of LDL-C assessment and improves CVD risk management in clinical practice.

Association Between Remnant Cholesterol and Nonalcoholic Fatty Liver Disease: A Systemic Review and Meta-Analysis.

Lipid disorders are related to the risk of nonalcoholic fatty liver disease (NAFLD). Remnant cholesterol (RC), a nonclassical and once-neglected risk factor for NAFLD, has recently received new attention. In this study, we assessed the relationship between the RC levels and NAFLD risk. We searched across PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure, with no restrictions on publication languages. Retrospective cohort studies and cross-sectional studies were enrolled from the inception of the databases until August 6, 2023. A random-effect model was applied to construct the mean difference, and a 95% confidence interval was applied to assess the relationship between the RC levels and NAFLD risk. We used two methods to estimate RC levels: Calculated-1 subtracts low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol from total cholesterol; Calculated-2 uses the Friedewald formula for LDL-C when triglycerides are <4.0 mmol/L, otherwise directly measured. A total of 265 published studies were selected through preliminary retrieval. Of these, six studies met the inclusion requirements and were enrolled in the meta-analysis. The RC level in the NAFLD group was significantly higher than that in the non-NAFLD group (mean difference: 0.18, 95% confidence interval: 0.10-0.26, P < 0.00001). We conducted subgroup analyses of computational methods and geographic regions. Notably, in the subgroup analysis of Calculation Method 2, the NAFLD group had significantly higher RC levels than the non-NAFLD group. On the other hand, in Calculation Method 1, the difference between the two groups was insignificant. In both the Asian and non-Asian populations, the RC levels were significantly higher in the NAFLD group than in the non-NAFLD group. The association of RC with an increased NAFLD risk was not dependent on the triglyceride. This meta-analysis suggests that elevated RC levels are associated with an increased risk of NAFLD. In addition to the conventional risk factors for fatty liver, clinicians should be concerned about the RC levels in the clinic.

Cardiovascular Risk Assessment in Women with Psoriasis

Objectives: Psoriasis is a chronic inflammatory skin disease. The exact cause of psoriasis is unclear; nevertheless, it is thought to be complex including several key components such as genetic predisposition, triggers from the environment, skin barrier disruption, and immunological dysfunction. About 85–90% of all psoriatic patients present with plaque type of psoriasis. The systemic nature of psoriasis makes an independent risk factor for cardiac disease. The main objective is to find the association between lipid profile, arterial stiffness, and psoriasis among female patients. Materials and Methods: Female patients with psoriasis in the age group of 20–50 years were selected. The duration of the study was 1 year. For lipid profile, after 12 h of fasting, 5 mL of blood was taken and analyzed by kit method using Transasia RX 1000. Low-density lipoprotein (LDL) cholesterol concentrations were estimated using the Friedewald formula. Arterial stiffness was measured using an oscillometric noninvasive arteriography. Right brachial ankle pulse wave velocity (RbaPWV), left brachial ankle pulse wave velocity (LbaPWV), and carotid femoral pulse wave velocity were measured in cm/s. Results: In the present study, 28% of the females were &lt;38 years and 44% of females were in the range of 39–46 years. The mean value of cholesterol was (263.66 ± 47.74), Triglyceride (188.38 ± 27.56), high-density lipoprotein (HDL) (50.06 ± 18.05) LDL (171.60 ± 33.98), and very LDL (89.74 ± 13.361) mg/dL, respectively. Significant correlation was found between LbaPWV and Psoriasis (0.03), HDL and psoriasis (0.04), and psoriasis and RbaPWV (0.01). Conclusion: We conclude that psoriasis patients have hyperlipidemia, which will increase arterial stiffness and may lead to cardiovascular disorders (CVDs). Variables such as lipid profiles and arterial stiffness may be used as screening tools for the early detection of CVDs.

The Evaluation of Lipid-Lowering Treatment in Patients with Acute Coronary Syndrome in a Hungarian Invasive Centre in 2015, 2017, and during the COVID-19 Pandemic-The Comparison of the Achieved LDL-Cholesterol Values Calculated with Friedewald and Martin-Hopkins Methods.

Background/Objectives: Patients with acute coronary syndrome (ACS) represent a vulnerable population. We aimed to investigate serum lipid levels of patients with ACS upon admission and during one year of the COVID-19 pandemic in a rural county hospital, and compared these findings with the data of patients with ACS in 2015 and 2017. The secondary aim of this paper was the comparison of the LDL-C values calculated with the Friedewald and Martin-Hopkins methods. Methods: A retrospective analysis of lipid-lowering data of patients treated with ACS in 2015, 2017 and in a COVID-19 year (1 April 2020-31 March 2021) was performed; the patient's numbers were 454, 513 and 531, respectively. Results: In the COVID-19 period one year after the index event, only 42% of the patients had lipid values available, while these ratios were 54% and 73% in 2017 and in 2015, respectively. Using the Friedewald formula, in the COVID-19 era the median of LDL cholesterol (LDL-F) was 1.64 (1.09-2.30) mmol/L at six months and 1.60 (1.19-2.27) mmol/L at one year, respectively. These values were 1.92 (1.33-2.27) mmol/L and 1.73 (1.36-2.43) mmol/L using the Martin-Hopkins method (LDL-MH). The LDL-F yielded significantly lower values (15% lower at six months, p = 0.044; and 8% lower at one year, p = 0.014). The LDL-F reached the previous target of 1.8 mmol/L during the COVID-19 pandemic 36% at one year vs. 48% in 2017, and 37% in 2015. The recent target LDL-C level of 1.4 mmol/L was achieved in 22% of cases in the COVID-19 pandemic, 16% in 2015 and 19% in 2017. Conclusions: A significantly lower proportion of patients with ACS had available lipid tests during the COVID-19 pandemic. Besides the lower number of available samples, the proportion of achieved 1.4 mmol/L LDL-C target lipids was stable. More rigorous outpatient care in the follow-up period may help to improve the quality of lipid lowering treatments and subsequent secondary cardiovascular prevention. If direct LDL-C determination is not available, we prefer the LDL calculation with the Martin-Hopkins method.

Does LDL-C determination method affect statin prescribing for primary prevention? A register-based study in Southern Denmark.

Examine whether the low-density lipoprotein cholesterol (LDL -C) determination method influences the rate of statin initiation for primary prevention of cardiovascular disease. We conducted a register-based retrospective study in the Region of Southern Denmark. Two hospital-based laboratories in the region directly measure LDL -C whereas four laboratories calculate LDL -C using Friedewald's formula. Physicians do not choose which method is used. We included all statin-naïve patients ≥40 years with no history of cardiovascular disease, diabetes, or chronic kidney disease, who had their LDL -C determined during 2018-2019. There were 202807 people who had LDL -C determined during the study period (median age 59 years, 44% women) of which 37% had a direct LDL -C measurement. The median reported LDL -C was 3.40mmol/L [interquartile range (IQR) 2.90-4.00] for those with a direct measurement vs. 3.00mmol/L (IQR 2.40-3.50) for those with calculated LDL -C. For those with direct measurement, re-calculated LDL -C (using Friedewald's formula) was 0.35mmol/L lower than the reported direct LDL -C measurement. Among those with directly measured LDL -C, 3.6% initiated statins compared with 2.7% of those with a calculated LDL -C. Direct LDL -C measurement led to higher odds of having a statin initiated compared with calculated LDL -C (adjusted odds ratio 1.23, 95% CI 1.17-1.30); for those with triglycerides >1.7mmol/L the adjusted odds ratio was 1.41 (95% CI 1.30-1.52). Differences in the reporting of LDL -C from laboratories using different methods have a substantial influence on physician's decisions to prescribe statins.

Evaluation of 13 Formulae for Calculated LDL-C Using Direct Homogenous Assay in a South Indian Population.

LDL cholesterol (LDL-C) is regarded as a significant therapeutic target and a known risk factor for atherosclerosis. It can be calculated using the results of the other lipid tests or tested directly. Despite its shortcomings, the Friedewald formula is most frequently utilized since it is simple and practical. Until now, several formulae have been proposed for calculating LDL-C; however, their accuracy has not been evaluated across different populations. We sought to evaluate the validity of calculated LDL-C by comparing the findings with values acquired by the direct homogeneous technique, utilizing 13 distinct formulae from the literature. This study was a retrospective observational study conducted for a year at SRIHER, Chennai, Tamil Nadu, India. From the total 25 043 patients who had their serum lipid profile tested, 16 314 participants had their fasting blood sugar and fasting lipid profile measured simultaneously, and they were chosen for the research. The de Cordova, Chen, Martin/Hopkins (initial), and Teerakanchana equations correlated well with the direct LDL-C assay. When the dataset was stratified according to triglycerides, the Chen and Martin/Hopkins initial equations had the better measurement of agreement compared to other equations. The Martin/Hopkins initial equation outperformed all the other equations when the whole dataset irrespective of the triglyceride population was considered. Our study suggests that the Martin/Hopkins initial equation outperformed all the other equations and can be used as an alternative to direct LDL-C measurement in a South Indian population.

The Role of Serum Lipids in Predicting Suicidal Ideation in Isotretinoin Therapy for Acne.

Previous studies have demonstrated that lipids could play a role in suicidal ideation and the pathogenesis of psychiatric diseases. The present study aims to investigate the correlation between variations in serum lipid concentration, a side effect of isotretinoin (ITT), psychiatric symptoms, and suicidal ideation in acne vulgaris patients under ITT treatment. Thestudy was completed with 41 acne patients. Patients were analyzed with the sociodemographic and clinical data form, Beck depression inventory (BDI), Beck anxiety inventory (BAI), Beck Suicidal Ideation Scale (BSS), and Brief Psychiatric Rating Scale (BPRS) at the beginning and on the third month of treatment. Lipid levels [serum total cholesterol (TC), triglyceride (TG) and high-density lipoprotein cholesterol (HDL)] were measured using the automatic chemistry analyzer (Beckman AU-5800). Serum low-density lipoprotein cholesterol (LDL) values were estimated with the Friedewald formula. A statistically significant correlation was determined between the BSS scores and TC, TG, and LDL parameters at the beginning of treatment and the control date. Thus, it was determined that there was a negative weak correlation between BSS and TC parameters (r = -0.403; P = .009), a moderate negative correlation between BSS and TG (r = -0.526; P < .001), and a weak negative correlation between BSS and LDL (r = -0.421; P = .006). Furthermore, there were statistically significant changes between the BDI and BAI scores at the beginning of treatment and the third month ( P = 0.016 and P = .001, respectively). Although an increase was observed in BSS and BPRS after the treatment compared to pretreatment, the increase was not statistically significant. The present study findings revealed that serum lipid levels could be associated with psychiatric side effects in patients under ITT treatment. But, this must not be the only way to detect the risk when we consider that serum lipid levels that have been associated with suicidal ideation, depression, and several psychiatric diseases have the potential to be an important indicator. In this context, our preliminary results open the doors to a new perspective in this regard, using the concept of blood lipid optimization. These findings need to be considered preliminary and supported by large samples.

Lipid Profile and Atherogenic Risk Assessment in Nigerian Breast Cancer Patients – A Cross-Sectional Study

Background The lipid profile and atherogenic risk indices in Nigerian breast cancer patients are largely unknown. This study evaluated the lipid profile and atherogenic risk indices of breast cancer patients in Nigeria. Methods This study involved 45 primarily diagnosed breast cancer patients and 50 normal control subjects. Total cholesterol, triglyceride, and High-density lipoprotein cholesterol (HDL-C) were measured. Low-density lipoprotein cholesterol (LDL-C) was calculated according to Friedewald formula. Atherogenic index of plasma (AIP), Atherogenic coefficient (AC), TC/HDL-C (Castelli I) and LDL-C/HDL-C (Castelli II) risk indices were all calculated. The Framingham risk assessment was calculated and categorized. Results The study group had significantly higher triglycerides (TG), and atherogenic indices than the control group (p < 0.001), while HDL-Cholesterol (HDL-C) was significantly lower in the study group (p < 0.001). Total cholesterol and LDL-Cholesterol (LDL-C) had a significant positive correlation with age (r = 0.283, p < 0.018; r = 0.272, p < 0.023); TG was significantly positively correlated with systolic and diastolic blood pressure (r = 0.320. p < 0.007; r = 0.334, p < 0.005); HDL-C had a significant negative correlation with BMI, systolic and diastolic blood pressure (r = −0.252, p < 0.035; r = −0.29, p < 0.015; r = −0.329, p < 0.005). The lipid ratios (TC/HDL-C, LDL-C/HDL-C) were significantly positively correlated with body mass index (BMI), systolic and diastolic blood pressure. The Framingham Risk Score showed that only 2 subjects in the study group (4.4%) were at a high risk of having a cardiovascular event. Conclusion Breast cancer patients have a higher prevalence of dyslipidaemia, and cardiovascular risk than the normal population.

Comparison of the Friedewald and Vujovic methods with the calculated LDL concentration in a biochemical auto-analyzer.

To compare the concentration of Low-Density Lipoprotein (LDL-c) obtained using the Friedewald formula with those obtained directly with the RAYTO CHEMRAY 120 autoanalyzer. Cross-sectional study. We evaluated outpatients with a medical request for a lipid profile study (total cholesterol, triglycerides, LDL, and HDL). The analyses were carried out in a RAYTO CHEMRAY 120 autoanalyzer under the principle of spectrophotometry. We obtained LDL-c using the Friedewald and Vujovic formulas. We evaluated 199 individuals whose direct LDL concentration averages were measured by the RAYTO CHEMRAY 120 equipment. Those calculated by the Friedewald and Vujovic formulas were 129.97 ± 32.66, 119.28 ± 30.44, and 127.01 ± 32.01, respectively, and in all cases, significant differences (P < 0.001) were observed with the RAYTO analyzer. In both cases a low positive bias was found with the RAYTO analyzer.. The Passing-Bablok and Deming's regressions showed a linear correlation between both methods (Friedewald and Vujovic) with the LDL values obtained with the Rayto autoanalyzer. Our study found that the Friedewald and Vujovic methods are good predictors of LDL cholesterol levels and have a low level of bias. Therefore, they could be used as potential predictors.

Correlation of LDL Cholesterol Levels Using Friedewald Formula and Direct Method Homogeneous Assay

LDL (Low-Density Lipoprotein ) is a lipoprotein that plays a role in transporting fat fractions, especially cholesterol from the liver to peripheral cells. LDL cholesterol examination can be done by 2 methods, namely indirect and direct methods. Measurement of LDL cholesterol levels by indirect method (Fredewald Formula Fredewald ) is done by involving other examinations, namely Total cholesterol, HDL cholesterol, and triglycerides, while the direct method ( homogeneous Assay ) has full automatic capability in determining LDL cholesterol directly. The purpose of the study was to determine whether there were differences in LDL cholesterol levels using Indirect and Direct methods. The research method used the type of analytical observational research. The study was conducted in the main Clinical Laboratory of Mekarsari using 30 samples with the Total Sampling technique. The test used is the Paired-Samples T Test. The average result of LDL cholesterol levels using the indirect method was 107.37 mg/dl and the direct method was 117.10 mg/dl. The test results of different Paired-samples T Test obtained sig.0.000 due to GIS.&lt;0.05 it can be concluded that there is a significant difference between LDL cholesterol between the indirect method ( Friedewald formula ) and direct method (homogeneous Assay)

A comparative evaluation of low-density lipoprotein cholesterol estimation: Machine learning algorithms versus various equations

BackgroundGiven the critical importance of Low-density lipoprotein cholesterol (LDL-C) levels in determining cardiovascular risk, it is essential to measure LDL-C accurately. Since the Friedewald formula generates incorrect predictions in many circumstances, new equations have been developed to overcome the Friedewald equations' shortcomings. This study aimed to compare estimated LDL-C with directly measured LDL-C (dLDL-C), as well as their performance in predicting LDL-C, utilizing Friedewald, extended Martin–Hopkins, Sampson, de Cordova, and Vujovic formulas and five machine learning (ML) algorithms. MethodsA total of 29,504 samples from the ISLAB-2 Core Laboratory were included in the study. All statistical analysis was performed using R version 4.1.2. Statistical Language. ResultsBayesian-Regularized Neural Network (BRNN) (r = 0.957) and Random Forest (RF) (r = 0.957) algorithms showed a higher correlation with dLDL-C than the other equations in all-testing dataset. All ML algorithms demonstrated less bias than pre-existing LDL-C equations with dLDL-C and outperformed the LDL-C estimation equations in terms of concordance in all-testing dataset. ConclusionsThe results of our research indicate that when compared to conventional equations, ML algorithms are much more effective in predicting LDL-C. ML algorithms, aided by a vast dataset, could have the capability to predict LDL-C levels even in cases where triglyceride levels are high, unlike the limited usage of Friedewald formula.

Diagnostic Accuracy Study of Direct and Formula Based Method for Estimation of LDL Cholesterol

Introduction: Increased LDL-C is a well-known risk factor for cardiovascular disease. Also, LDL-C is used for risk stratification and in planning appropriate treatment. This requires the accurate measurement of LDL-C. Though β quantification is the reference method for LDL-C estimation it can’t be used routinely. Even though homogenous assays are available, some clinical laboratories use the Friedewald formula, which has its disadvantages. Aim &amp; Objectives: To identify which LDL-C formula best correlates with direct LDL-C among various levels of TG. Study Design: A retrospective diagnostic accuracy study. Materials and Methods: Complete lipid data of 15,094 was obtained from the hospital information system. Based on TG level data, it was grouped into TG &lt;100 mg/dl (N=6022) and TG 100-200 mg/dl (9072). Direct homogenous assay was used to measure LDL-C. LDL-C was calculated using seven formulae (Friedewald, Hattori, de Cordova, Vujovic, Anandaraja, Chen, and Sampson). Results: Correlation between direct and formula-based LDL-C by ICC showed maximum correlation by Vujovic (0.978). Bland Altman plot between Vujovic and the direct method shows a bias of -0.38 and it may overestimate or underestimate by 23 mg/dl. Conclusion: LDL-C calculated using Vujovic showed maximum correlation with direct homogenous assay when TG &lt;200 mg/dl.

The non-HDL-C to APOB ratio as a predictor of inaccurate LDL-C measurement in patients with chronic intrahepatic cholestasis and jaundice: a retrospective study.

Cholestasis is characterized by the accumulation of bile in the liver or biliary system due to obstruction or impaired flow, necessitating lipid profiling to assess lipid metabolism abnormalities. Intrahepatic cholestasis, being the most significant type of cholestasis, further complicates the assessment of lipid abnormalities. However, the accuracy of low-density lipoprotein cholesterol (LDL-C) measurement in intrahepatic cholestasis patients remains uncertain. This study aimed to evaluate the consistency of the homogeneous assay and the Friedewald formula in detecting LDL-C levels and identify factors influencing LDL-C test results in intrahepatic patients with cholestasis. Retrospective analysis of laboratory data was conducted on intrahepatic cholestatic patients. Correlations between LDL-C values obtained using the homogeneous method (LDL-C(D)) and the Friedewald formula (LDL-C(F)), as well as associations between high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (ApoA1), LDL-C(D) and LDL-C(F), and apolipoprotein B (ApoB), were analyzed. Logistic regression analyses were employed to identify diagnostic indicators for inaccurate LDL-C measurements in intrahepatic cholestatic patients. Compared to patients with intrahepatic cholestasis without jaundice, the correlation between LDL-C(F) and LDL-C(D) was weaker in those with jaundice. Additionally, HDL-C exhibited a strong correlation with ApoA1 in both jaundice and non-jaundice cholestasis cases. Elevated non-HDL-C to APOB ratio (NH-C/B Ratio) levels (>4.5) were identified as a reliable predictor of inaccurate LDL-C measurements in patients with chronic intrahepatic cholestasis accompanied by jaundice. LDL-C measurement reliability is moderately weaker in patients with intrahepatic cholestasis accompanied by jaundice. Elevated levels of the NH-C/B ratio serve as a significant predictor of inaccurate LDL-C measurements in this chronic patient population, highlighting its clinical relevance for diagnostic assessments.