Does friedewald formula underestimate the risk of ischemic heart disease?

被引：12
作者：
Bansal E. [1 ]
Kaur N. [1 ]
机构：
[1] Department of Biochemistry, DMC and H, Ludhiana Punjab
来源：
Indian Journal of Clinical Biochemistry | 2014年 / 29卷 / 4期
关键词：
Calculated LDL; Direct LDL; Friedewald formula;
D O I：
10.1007/s12291-013-0392-2
中图分类号：
学科分类号：
摘要：
Traditionally Friedewald formula has been used to calculate low density lipoprotein cholesterol (LDL-C) concentration though now direct homogenous methods for its measurement are also available. Clinical guidelines recommend the use of calculated LDL-C to guide therapy because the evidence base for cholesterol management is derived almost exclusively from trials that use calculated LDL, with direct measurement of LDL-C being reserved for those patients who are non fasting or with significant hypertriglyceridemia. In this study our aim was to compare calculated and direct LDL and their variation at different cholesterol and triglyceride levels. Fasting lipid profile estimation was done on 503 outpatients in a tertiary hospital. Both direct and calculated LDL were then compared. Mean fasting direct LDL was found to be higher than calculated LDL in 87.1 % of subjects by 8.64 ± 8.35 mg/dl. This difference was seen a all levels of cholesterol and triglyceride. Using 130 mg/dl LDL cholesterol as cut off fewer subjects were classified as high risk by calculated LDL than direct LDL. In conclusion, direct LDL is higher than calculated LDL. Compared with direct measurement, the Friedewald calculation underestimates the risk for ischemic heart disease. © 2013 Association of Clinical Biochemists of India.
引用
收藏
页码：496 / 500
页数：4
相关论文
共 21 条
  • [1] Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S), Lancet, 344, pp. 1383-1389, (1994)
  • [2] Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels, N Engl J Med, 339, pp. 1349-1357, (1998)
  • [3] Ridker P.M., Stampfer M.J., Rifai N., Novel risk factors for systemic atherosclerosis, J Am Med Assoc, 285, pp. 2481-2485, (2001)
  • [4] Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III), J Am Med Assoc, 285, pp. 2486-2497, (2001)
  • [5] Bachorick P.S., Ross J.W., For the National Cholesterol Education Program Working Group on Lipoprotein Measurements. National Cholesterol Education Program recommendations for measurement of low-density lipoprotein cholesterol: Executive summary, Clin Chem, 41, pp. 1414-1420, (1995)
  • [6] Bairaktari E.T., Seferiadis K.I., Elisaf M.S., Evaluation of methods for the measurement of low-density lipoprotein cholesterol, J Cardiovasc Pharmacol Ther, 10, pp. 45-54, (2005)
  • [7] Nauck M., Warnick G.R., Rifai N., Methods for measurement of LDL-cholesterol: A critical assessment of direct measurement by homogeneous assays versus calculation, Clin Chem, 48, pp. 236-254, (2002)
  • [8] Friedewald W.T., Levy R.I., Fredrickson D.S., Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge, Clin Chem, 18, pp. 499-502, (1972)
  • [9] Tighe D.A., Ockene I.S., Reed G., Nicolosi R., Calculated low density lipoprotein cholesterol levels frequently underestimate directly measured low density lipoprotein cholesterol determinations in patients with serum triglyceride levels or4.52 mmol/l: An analysis comparing the LipiDirect
  • [10] b® magnetic LDL assay with the Friedewald calculation, Clin Chim Acta, 365, pp. 236-242, (2006)
123