Chinelo P Onyenekwu1, Mariza Hoffmann2, Francois Smit3, Tandi E Matsha4, Rajiv T Erasmus5. 1. Department of Chemical Pathology, Tygerberg Hospital and the National Health Laboratory Services, Stellenbosch University, Parow, South Africa Department of Clinical Pathology, Lagos University Teaching Hospital, Idi-Araba, Nigeri. 2. Department of Chemical Pathology, Tygerberg Hospital and the National Health Laboratory Services, Stellenbosch University, Parow, South Africa mariza@sun.ac.za. 3. Department of Biomedical Sciences, Cape Peninsula University of Technology, Bellville, South Africa PathCare Laboratories, Mediclinic Vergelegen, Somerset West, South Africa. 4. Department of Biomedical Sciences, Cape Peninsula University of Technology, Bellville, South Africa. 5. Department of Chemical Pathology, Tygerberg Hospital and the National Health Laboratory Services, Stellenbosch University, Parow, South Africa.
Abstract
BACKGROUND: The accurate determination of low density lipoprotein cholesterol (LDL-c) is pertinent in clinical practice. Most laboratories employ the Friedewald formula, for convenient estimation of LDL-c, despite its shortfalls. Different formulae have been proposed for use, for more accurate but convenient estimation of LDL-c. Here, we compare a new formula recently proposed by de Cordova et al., with that of Friedewald and LDL-c determined by a homogeneous assay. We also assess its performance at very low TG levels against the modified Friedewald formula recommended by Ahmadi et al. METHODS: A database of 587 adults from the 'Establishing Reference Intervals for Selected Analytes in South Africa' study was utilized. Fasting samples were assayed for lipids. LDL-c was determined by the Daiichi method. Performance of the Friedewald and the de Cordova formulae was compared. This was exclusively repeated at very low TG levels (<1.13 mmol/L), this time, including the Ahmadi formula. RESULTS: The Friedewald formula and the de Cordova formula both had high correlations with the direct LDL-c (r = 0.98 and r = 0.97, respectively), although the latter showed an inconsistent bias at different LDL-c levels. The two formulae had a higher correlation (r = 0.98) than the Ahmadi formula (r = 0.92) at very low TG levels. CONCLUSIONS: The Friedewald formula showed better agreement with the direct LDL-c than the de Cordova formula, at various LDL-c levels, in our population. It also performed better than the Ahmadi formula at very low TG levels. We therefore advise that it remains the formula of choice for LDL-c estimation in South Africa.
BACKGROUND: The accurate determination of low density lipoprotein cholesterol (LDL-c) is pertinent in clinical practice. Most laboratories employ the Friedewald formula, for convenient estimation of LDL-c, despite its shortfalls. Different formulae have been proposed for use, for more accurate but convenient estimation of LDL-c. Here, we compare a new formula recently proposed by de Cordova et al., with that of Friedewald and LDL-c determined by a homogeneous assay. We also assess its performance at very low TG levels against the modified Friedewald formula recommended by Ahmadi et al. METHODS: A database of 587 adults from the 'Establishing Reference Intervals for Selected Analytes in South Africa' study was utilized. Fasting samples were assayed for lipids. LDL-c was determined by the Daiichi method. Performance of the Friedewald and the de Cordova formulae was compared. This was exclusively repeated at very low TG levels (<1.13 mmol/L), this time, including the Ahmadi formula. RESULTS: The Friedewald formula and the de Cordova formula both had high correlations with the direct LDL-c (r = 0.98 and r = 0.97, respectively), although the latter showed an inconsistent bias at different LDL-c levels. The two formulae had a higher correlation (r = 0.98) than the Ahmadi formula (r = 0.92) at very low TG levels. CONCLUSIONS: The Friedewald formula showed better agreement with the direct LDL-c than the de Cordova formula, at various LDL-c levels, in our population. It also performed better than the Ahmadi formula at very low TG levels. We therefore advise that it remains the formula of choice for LDL-c estimation in South Africa.
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