Comparison of formulas for calculating low-density lipoprotein cholesterol in general population and high-risk patients with cardiovascular disease

Hansol Choi, Jee Seon Shim, Myung Ha Lee, Young Mi Yoon, Dong Phil Choi, Hyeon Chang Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and Objcetives: Low-density lipoprotein cholesterol (LDL-C), an established cardiovascular risk factor, can be generally determined by calculation from total cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. The aim of this study was to compare LDL-C estimations using various formulas with directly measured LDL-C in a community-based group and hospital-based group among the Korean population. Subjects and Methods: A total of 1498 participants were classified into four groups according to triglyceride concentrations as follows: <100, 100-199, 200-299, and ≥300 mg/dL. LDL-C was calculated using the Friedewald, Chen, Vujovic, Hattori, de Cordova, and Anandaraja formulas and directly measured using a homogenous enzymatic method. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Passing & Bablok regression, and Bland-Altman plots were used to evaluate the performance of six formulas. Results: The Friedewald formula had the highest accuracy (ICC=0.977; 95% confidence interval 0.974-0.979) of all the triglyceride ranges, while the Vujovic formula had the highest accuracy (ICC=0.876; 98.75% confidence interval 0.668-0.951) in people with triglycerides ≥300 mg/dL. The mean difference was the lowest for the Friedewald formula (0.5 mg/dL) and the percentage error was the lowest for the Vujovic formula (30.2%). However, underestimation of the LDL-C formulas increased with triglyceride concentrations. Conclusion: The accuracy of the LDL-C formulas varied considerably with differences in triglyceride concentrations. The Friedewald formula outperformed other formulas for estimating LDL-C against a direct measurement and the Vujovic formula was suitable for hypertriglyceridemic samples; it could be used as an alternative cost-effective tool to measure LDL-C when the direct measurement cannot be afforded.

Original languageEnglish
Pages (from-to)688-698
Number of pages11
JournalKorean Circulation Journal
Volume46
Issue number5
DOIs
Publication statusPublished - 2016 Sep

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LDL Cholesterol
Cardiovascular Diseases
Triglycerides
Population
Confidence Intervals
HDL Cholesterol
Cholesterol
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Comparison of formulas for calculating low-density lipoprotein cholesterol in general population and high-risk patients with cardiovascular disease",
abstract = "Background and Objcetives: Low-density lipoprotein cholesterol (LDL-C), an established cardiovascular risk factor, can be generally determined by calculation from total cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. The aim of this study was to compare LDL-C estimations using various formulas with directly measured LDL-C in a community-based group and hospital-based group among the Korean population. Subjects and Methods: A total of 1498 participants were classified into four groups according to triglyceride concentrations as follows: <100, 100-199, 200-299, and ≥300 mg/dL. LDL-C was calculated using the Friedewald, Chen, Vujovic, Hattori, de Cordova, and Anandaraja formulas and directly measured using a homogenous enzymatic method. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Passing & Bablok regression, and Bland-Altman plots were used to evaluate the performance of six formulas. Results: The Friedewald formula had the highest accuracy (ICC=0.977; 95{\%} confidence interval 0.974-0.979) of all the triglyceride ranges, while the Vujovic formula had the highest accuracy (ICC=0.876; 98.75{\%} confidence interval 0.668-0.951) in people with triglycerides ≥300 mg/dL. The mean difference was the lowest for the Friedewald formula (0.5 mg/dL) and the percentage error was the lowest for the Vujovic formula (30.2{\%}). However, underestimation of the LDL-C formulas increased with triglyceride concentrations. Conclusion: The accuracy of the LDL-C formulas varied considerably with differences in triglyceride concentrations. The Friedewald formula outperformed other formulas for estimating LDL-C against a direct measurement and the Vujovic formula was suitable for hypertriglyceridemic samples; it could be used as an alternative cost-effective tool to measure LDL-C when the direct measurement cannot be afforded.",
author = "Hansol Choi and Shim, {Jee Seon} and Lee, {Myung Ha} and Yoon, {Young Mi} and Choi, {Dong Phil} and Kim, {Hyeon Chang}",
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Comparison of formulas for calculating low-density lipoprotein cholesterol in general population and high-risk patients with cardiovascular disease. / Choi, Hansol; Shim, Jee Seon; Lee, Myung Ha; Yoon, Young Mi; Choi, Dong Phil; Kim, Hyeon Chang.

In: Korean Circulation Journal, Vol. 46, No. 5, 09.2016, p. 688-698.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of formulas for calculating low-density lipoprotein cholesterol in general population and high-risk patients with cardiovascular disease

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AU - Shim, Jee Seon

AU - Lee, Myung Ha

AU - Yoon, Young Mi

AU - Choi, Dong Phil

AU - Kim, Hyeon Chang

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N2 - Background and Objcetives: Low-density lipoprotein cholesterol (LDL-C), an established cardiovascular risk factor, can be generally determined by calculation from total cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. The aim of this study was to compare LDL-C estimations using various formulas with directly measured LDL-C in a community-based group and hospital-based group among the Korean population. Subjects and Methods: A total of 1498 participants were classified into four groups according to triglyceride concentrations as follows: <100, 100-199, 200-299, and ≥300 mg/dL. LDL-C was calculated using the Friedewald, Chen, Vujovic, Hattori, de Cordova, and Anandaraja formulas and directly measured using a homogenous enzymatic method. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Passing & Bablok regression, and Bland-Altman plots were used to evaluate the performance of six formulas. Results: The Friedewald formula had the highest accuracy (ICC=0.977; 95% confidence interval 0.974-0.979) of all the triglyceride ranges, while the Vujovic formula had the highest accuracy (ICC=0.876; 98.75% confidence interval 0.668-0.951) in people with triglycerides ≥300 mg/dL. The mean difference was the lowest for the Friedewald formula (0.5 mg/dL) and the percentage error was the lowest for the Vujovic formula (30.2%). However, underestimation of the LDL-C formulas increased with triglyceride concentrations. Conclusion: The accuracy of the LDL-C formulas varied considerably with differences in triglyceride concentrations. The Friedewald formula outperformed other formulas for estimating LDL-C against a direct measurement and the Vujovic formula was suitable for hypertriglyceridemic samples; it could be used as an alternative cost-effective tool to measure LDL-C when the direct measurement cannot be afforded.

AB - Background and Objcetives: Low-density lipoprotein cholesterol (LDL-C), an established cardiovascular risk factor, can be generally determined by calculation from total cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. The aim of this study was to compare LDL-C estimations using various formulas with directly measured LDL-C in a community-based group and hospital-based group among the Korean population. Subjects and Methods: A total of 1498 participants were classified into four groups according to triglyceride concentrations as follows: <100, 100-199, 200-299, and ≥300 mg/dL. LDL-C was calculated using the Friedewald, Chen, Vujovic, Hattori, de Cordova, and Anandaraja formulas and directly measured using a homogenous enzymatic method. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Passing & Bablok regression, and Bland-Altman plots were used to evaluate the performance of six formulas. Results: The Friedewald formula had the highest accuracy (ICC=0.977; 95% confidence interval 0.974-0.979) of all the triglyceride ranges, while the Vujovic formula had the highest accuracy (ICC=0.876; 98.75% confidence interval 0.668-0.951) in people with triglycerides ≥300 mg/dL. The mean difference was the lowest for the Friedewald formula (0.5 mg/dL) and the percentage error was the lowest for the Vujovic formula (30.2%). However, underestimation of the LDL-C formulas increased with triglyceride concentrations. Conclusion: The accuracy of the LDL-C formulas varied considerably with differences in triglyceride concentrations. The Friedewald formula outperformed other formulas for estimating LDL-C against a direct measurement and the Vujovic formula was suitable for hypertriglyceridemic samples; it could be used as an alternative cost-effective tool to measure LDL-C when the direct measurement cannot be afforded.

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