Dataset Information

Comparison and Validation of 10 Equations Including a Novel Method for Estimation of LDL-cholesterol in a 168,212 Asian Population.

ABSTRACT: Low-density lipoprotein cholesterol (LDL-C) is frequently estimated using the empirical Friedewald equation. We compared the accuracy of the novel equation named as the 180-cell method (180-c), which estimates LDL-C using a stratification approach, to those of 9 previously suggested formulas, including the Friedewald equation.We compared the accuracy of 10 equations by calculating intraclass correlation coefficient (ICC) and weighted kappa index in relation to direct LDL-C measurement values. Two independent populations used in the validation were the Severance Hospital LDL-C (SHL) registry (n?=?164,358) and the Korea National Health and Nutrition Examination Survey (KNHANES) 2009 to 2010 (n?=?3,854), each representing the hospital patient population and the general Korean population, respectively.The 180-c and DeLong equations showed the highest ICCs, indicating the best agreement with direct LDL-C measurement. The 180-c and Chen equations showed the highest kappa indices. For the hypertriglyceridemic subpopulation from SHL, the 180-c equation showed the best agreement with direct LDL-C measurement in terms of ICC.We compared the novel 180-c method for LDL-C estimation with 9 previous formulas in a non-US population as the first external validation. The 180-c equation, with Chen equation, appeared to be more accurate than the Friedewald equation. Although the DeLong equation showed better performance in the hypertriglyceridemic subpopulation, the 180-c equation performed appropriately in Asian population.

SUBMITTER: Rim JH

PROVIDER: S-EPMC4998773 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Comparison and Validation of 10 Equations Including a Novel Method for Estimation of LDL-cholesterol in a 168,212 Asian Population.

Rim John Hoon JH Lee Yong-Ho YH Lee Myung Ha MH Kim Ha Yan HY Choi Jiin J Lee Byung-Wan BW Kang Eun Seok ES Lee Hyun Chul HC Kim Jeong-Ho JH Lee Sang-Guk SG Cha Bong-Soo BS

Medicine 20160401 14

Low-density lipoprotein cholesterol (LDL-C) is frequently estimated using the empirical Friedewald equation. We compared the accuracy of the novel equation named as the 180-cell method (180-c), which estimates LDL-C using a stratification approach, to those of 9 previously suggested formulas, including the Friedewald equation.We compared the accuracy of 10 equations by calculating intraclass correlation coefficient (ICC) and weighted kappa index in relation to direct LDL-C measurement values. Tw ...[more]

PMID: 27057857

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Project description:BackgroundAlternatives to the Friedewald low-density lipoprotein cholesterol (LDL-C) equation have been proposed.ObjectiveTo compare the accuracy of available LDL-C equations with ultracentrifugation measurement.MethodsWe used the second harvest of the Very Large Database of Lipids (VLDbL), which is a population-representative convenience sample of adult and pediatric patients (N = 5,051,467) with clinical lipid measurements obtained via the vertical auto profile (VAP) ultracentrifugation method between October 1, 2015 and June 30, 2019. We performed a systematic literature review to identify available LDL-C equations and compared their accuracy according to guideline-based classification. We also compared the equations by their median error versus ultracentrifugation. We evaluated LDL-C equations overall and stratified by age, sex, fasting status, and triglyceride levels, as well as in patients with atherosclerotic cardiovascular disease, hypertension, diabetes, kidney disease, inflammation, and thyroid dysfunction.ResultsAnalyzing 23 identified LDL-C equations in 5,051,467 patients (mean±SD age, 56±16 years; 53.3% women), the Martin/Hopkins equation most accurately classified LDL-C to the correct category (89.6%), followed by the Sampson (86.3%), Chen (84.4%), Puavilai (84.1%), Delong (83.3%), and Friedewald (83.2%) equations. The other 17 equations were less accurate than Friedewald, with accuracy as low as 35.1%. The median error of equations ranged from -10.8 to 18.7 mg/dL, and was best optimized using the Martin/Hopkins equation (0.3, IQR-1.6 to 2.4 mg/dL). The Martin/Hopkins equation had the highest accuracy after stratifying by age, sex, fasting status, triglyceride levels, and clinical subgroups. In addition, one in five patients who had Friedewald LDL-C <70 mg/dL, and almost half of the patients with Friedewald LDL-C <70 mg/dL and triglyceride levels 150-399 mg/dL, had LDL-C correctly reclassified to >70 mg/dL by the Martin/Hopkins equation.ConclusionsMost proposed alternatives to the Friedewald equation worsen LDL-C accuracy, and their use could introduce unintended disparities in clinical care. The Martin/Hopkins equation demonstrated the highest LDL-C accuracy overall and across subgroups.

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Dataset Information

Comparison and Validation of 10 Equations Including a Novel Method for Estimation of LDL-cholesterol in a 168,212 Asian Population.

Publications

Comparison and Validation of 10 Equations Including a Novel Method for Estimation of LDL-cholesterol in a 168,212 Asian Population.

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