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SHR Neuro Cancer Cardio Lipid Metab Microb

Drobnik, S; Scharnagl, H; Samani, NJ; Braund, PS; Nelson, CP; Hollstein, T; Kassner, U; Dressel, A; Drobnik, W; März, W.
Evaluation of current indirect methods for measuring LDL-cholesterol.
Clin Chem Lab Med. 2025; Doi: 10.1515/cclm-2025-0024
Web of Science PubMed FullText FullText_MUG

 

Co-authors Med Uni Graz

März Winfried

Scharnagl Hubert

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Abstract:

OBJECTIVES: Accurately quantifying low-density lipoprotein cholesterol (LDL-C) is crucial for precise cardiovascular disease risk assessment and treatment decisions. The commonly used Friedewald equation (LDL-C_FW) has faced criticism for its tendency to underestimate LDL-C, particularly at high triglycerides (TG) or low LDL-C, potentially leading to undertreatment. Newer equations, such as those by Martin and Hopkins (LDL-C_MH) or Sampson (LDL-C_SN), have been proposed as alternatives. Our study aimed to assess the validity of LDL-C_FW, LDL-C_MH, and LDL-C_SN compared to ß-quantification (LDL-C_UC), the reference method recommended by the Lipid Research Clinics. METHODS: Using data from three studies comprising 5,738 datasets, LDL-C was determined with the four methods in samples with TG up to 5.65 mmol/L. We calculated median and mean differences, correlations, and used the Passing and Bablok regression for comparisons. Concordance/discordance analyses were conducted. RESULTS: All equations provided generally accurate LDL-C estimations with slight differences among them. At TG<1.69 mmol/L, no clinically significant divergences were observed. As TG values increased, LDL-C_FW offered the most accurate estimation, followed by LDL-C_SN, while LDL-C_MH exhibited increasingly strong positive bias. LDL-C_FW was not inferior to LDL-C_SN and LDL-C_MH in terms of concordance/discordance. CONCLUSIONS: LDL-C_FW generally provided reliable estimates of LDL-C in most samples, showing non-inferiority to LDL-C_SN or LDL-C_MH, thereby confirming its legitimacy for routine use. Since current treatment recommendations are based on studies employing LDL-C_FW, its replacement by alternatives is not justified.

Find related publications in this database (Keywords)

low-density lipoprotein cholesterol

beta quantification

Friedewald equation

Martin/Hopkins equation

Sampson equation

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