Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado, School of Medicine, Aurora, CO, USA.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Int J Cardiol. 2021 May 1;330:221-227. doi: 10.1016/j.ijcard.2021.02.009. Epub 2021 Feb 11.
Low-density lipoprotein-cholesterol (LDL-C) is the major determinant of cardiovascular disease (CVD) burden. Being the direct assays time consuming, expensive, not fully standardized and not worldwide available, indirect formulas represent the most used laboratory estimation of LDL-C. In this study we analyzed the accuracy of twelve formulas for LDL-C estimation in an Italian population of 114,774 individuals.
All lipid samples were analyzed using direct homogeneous assay. The population was divided into various subgroups based on triglycerides and directly dosed LDL-C (D-LDL) levels. Twelve formulas (Friedewald, DeLong, Hata, Hattori, Puavillai, Anandaraja, Ahmadi, Chen, Vujovic, de Cordova, Martin, and Sampson) were compared in terms of their mean absolute deviations and the correlation and concordance of their estimated LDL-C with the respective D-LDL values.
LCL-C measured by Friedewald formula and direct assay differed by more than 9 mg/dL. For D-LDL>115 mg/dl, we observed a concordance rate of only 55% between Friedewald and the respective D-LDL values. For TG<250 mg/dl, the proportion of reclassification between the different formulas and D-LDL was 14.1% with Vujovic, 14.4% Sampson, 15.9% DeLong, 16.5% Puavilai, 19.9% Martin, 21.9% Friedewald, 23.5% Chen, 29% Anandaraja, 31.1% Ahmadi, 31.5% Hata, 33.2% Hattori, and 44.4% with De Cordova formula.
Our study compared for the first time 12 different LDL-C formulas on a Southern European population of more than 100,000 people. 'Several formulas showed better accuracy compared to Friedewald. Sampson, Martin and Vujovic resulted the most accurate formulas.
低密度脂蛋白胆固醇（LDL-C）是心血管疾病（CVD）负担的主要决定因素。由于直接检测耗时、昂贵、不完全标准化且并非全球通用，间接公式成为 LDL-C 最常用的实验室估计方法。在这项研究中，我们分析了 114774 名意大利个体中 12 种 LDL-C 估计公式的准确性。
所有脂质样本均采用直接均相法进行分析。根据甘油三酯和直接测量的 LDL-C（D-LDL）水平，将人群分为多个亚组。比较了 12 种公式（Friedewald、DeLong、Hata、Hattori、Puavillai、Anandaraja、Ahmadi、Chen、Vujovic、de Cordova、Martin 和 Sampson）在平均绝对偏差方面的差异，以及它们估计的 LDL-C 与各自 D-LDL 值的相关性和一致性。
Friedewald 公式测量的 LDL-C 与直接检测值相差超过 9mg/dL。对于 D-LDL>115mg/dl，我们观察到 Friedewald 与各自 D-LDL 值的一致性率仅为 55%。对于 TG<250mg/dl，不同公式与 D-LDL 之间的重新分类比例为 14.1%（Vujovic）、14.4%（Sampson）、15.9%（DeLong）、16.5%（Puavilai）、19.9%（Martin）、21.9%（Friedewald）、23.5%（Chen）、29%（Anandaraja）、31.1%（Ahmadi）、31.5%（Hata）、33.2%（Hattori）和 44.4%（De Cordova）。
我们的研究首次在一个超过 10 万人的南欧人群中比较了 12 种不同的 LDL-C 公式。与 Friedewald 相比，“几种公式显示出更好的准确性。Sampson、Martin 和 Vujovic 是最准确的公式。
