Fawwad Asher, Sabir Rubina, Riaz Musarrat, Moin Hassan, Basit Abdul
Asher Fawwad, PhD. Associate Professor, Senior Research Scientist, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi Pakistan.
Rubina Sabir, M.Sc. Laboratory Manager, Clinical and Research Laboratory, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi Pakistan.
Pak J Med Sci. 2016 Jul-Aug;32(4):955-60. doi: 10.12669/pjms.324.9896.
There is a strong positive association between increased low-density lipoprotein cholesterol (LDL-C) and coronary heart disease (CHD). The accuracy of LDL-C estimation is essential and critically important. The aim of present study was to compare calculated LDL-C with direct homogeneous assay in patients with type 2 diabetes.
This observational study was carried out at Baqai Institute of Diabetology and Endocrinology (BIDE) from January 2011 to December 2013. A total of 9620 patients with type 2 diabetes were included in the study. Fasting blood glucose, total Cholesterol, triglyceride, HDL cholesterol and LDL cholesterol were obtained using standard methods. Calculated LDL-C was obtained by Friedewald formula.
Mean difference of measured and calculated LDL-C was found to be -0.25, 6.63 and 46.55 mg/dl at triglyceride levels < 150 mg/dl, 150 - 400 mg/dl and ≥ 400 mg/dl, respectively. The result shows that the difference between measured and calculated LDL-C increases as the triglyceride level increases.
The findings of our study suggested that calculated LDL-C was lower, as compared to measured LDL-C, which may cause misclassifications that may have an impact on therapeutic decisions in patients with diabetes. Calculated LDL-C may depend on triglyceride levels so LDL-C should be measured by direct assay in routine clinical laboratories.
低密度脂蛋白胆固醇（LDL-C）升高与冠心病（CHD）之间存在强正相关。LDL-C估算的准确性至关重要。本研究的目的是比较2型糖尿病患者计算得出的LDL-C与直接匀相测定法的结果。
本观察性研究于2011年1月至2013年12月在巴凯糖尿病与内分泌研究所（BIDE）进行。共纳入9620例2型糖尿病患者。采用标准方法测定空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇。计算得出的LDL-C采用Friedewald公式获得。
甘油三酯水平<150mg/dl、150 - 400mg/dl和≥400mg/dl时，测得的LDL-C与计算得出的LDL-C的平均差值分别为-0.25、6.63和46.55mg/dl。结果表明，随着甘油三酯水平升高，测得的LDL-C与计算得出的LDL-C之间的差异增大。
我们的研究结果表明，与测得的LDL-C相比，计算得出的LDL-C较低，这可能导致错误分类，进而可能影响糖尿病患者的治疗决策。计算得出的LDL-C可能取决于甘油三酯水平，因此在常规临床实验室中，LDL-C应采用直接测定法进行测量。
