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Friedewald's equation for calculating LDL-cholesterol: Is it the time to say "Goodbye" and adopt direct LDL cholesterol methods?

ABSTRACT: Objectives:To measure correlation and concordance between measured LDL cholesterol (mLDLc) and Friedewald's calculated LDL cholesterol (cLDLc). To compare the mLDLc and cLDLc values for various anthropometric measures and biochemical indices including insulin resistance, nephropathy, glycated hemoglobin and triglycerides. Methods:Two hundred thirty two subjects were included in this cross-sectional analysis from Jan-2016 to July-2017 from a target population visiting PNS HAFEEZ hospital. Mean age of the subjects was 46.56(±11.95) years (n=232). These subjects underwent clinical evaluation including measurement of anthropometric measurements, biochemical testing for fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), lipid profile, urine albumin creatinine ratio (UACR), and insulin. Correlation and concordance between mLDLc and Friedewald's cLDLc were measured. Finally, Comparison of risk evaluation for mLDLc and cLDLc between groups formulated based upon UACR (Based upon a cut off of 2.5 mg/g) and fasting triglycerides (Group-1 :< 1.0 mmol/L, Group-2: 1.0-1.99 mmol/L and Group-3 :> 1.99 mmol/) was carried out. Results:There was significant positive linear correlation between mLDLc and cLDLc [r=0.468, <0.001]. Kendall's Coefficient of concordance between mLDLc and cLDLc was 0.055 (p<0.001). Differences evaluated by one way ANOVA analysis for mLDLc between various triglycerides groups were only significant between group-1 and group-2 [{Group-1:Mean=2.40, (2.19-2.61), n=43}, {Group-2:Mean=2.81, (2.69-2.92), n=136}, [{Group-3:Mean=2.59,(2.37-2.81), n=53}],(p=0.004) in comparison to cLDLc [{Group-1:Mean=2.63, (2.43-2.84), n=43}, {Group-2:Mean=2.85, (2.76-2.93), n=136}, [{Group-3:Mean=2.75, (2.60-2.90), n=53}]. Calculated method for LDLc showed higher UACR than mLDLc. (p=0.021). Conclusion:cLDLc over estimates LDL-cholesterol in comparison to mLDLc. The correlation between cLDLc and mLDLc was only moderate. However, cLDLc provided better degree of risk prediction for nephropathy and glycated hemoglobin than mLDLc.

SUBMITTER: Khan SH

PROVIDER: S-EPMC6500835 | biostudies-other | 2019 Mar-Apr

REPOSITORIES: biostudies-other

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Friedewald's equation for calculating LDL-cholesterol: Is it the time to say "Goodbye" and adopt direct LDL cholesterol methods?

Khan Sikandar Hayat SH Niazi Najmusaqib Khan NK Sobia Farah F Fazal Nadeem N Manzoor Syed Mohsin SM Nadeem Ahmed A

Pakistan journal of medical sciences 20190301 2

<h4>Objectives</h4>To measure correlation and concordance between measured LDL cholesterol (mLDLc) and Friedewald's calculated LDL cholesterol (cLDLc). To compare the mLDLc and cLDLc values for various anthropometric measures and biochemical indices including insulin resistance, nephropathy, glycated hemoglobin and triglycerides.<h4>Methods</h4>Two hundred thirty two subjects were included in this cross-sectional analysis from Jan-2016 to July-2017 from a target population visiting PNS HAFEEZ ho ...[more]

PMID: 31086520

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Project description:BACKGROUND:Symptom clusters are conventionally distilled into a single score using composite scoring, which is based on the mathematical assumption that all symptoms are equivalently related to outcomes of interest; this may lead to a loss of important variation in the data. OBJECTIVES:This article compares two ways of calculating a single score for a symptom cluster: a conventional, hypothesis-driven composite score versus a data-driven, reduced rank regression score that weights the symptoms based on their individual relationships with key outcomes. METHODS:We conducted a secondary analysis of psychoneurological symptoms from a sample of 356 low-income mothers. Four of the psychoneurological symptoms (fatigue, cognitive dysfunction, sleep disturbance, and depressed mood) were measured with the Center for Epidemiological Studies Depression Scale; the fifth (pain) was measured using an item from the Medical Outcomes Study 12-item Short Form Health Survey (SF-12). Mothers' function was measured using the 12-item Short Form Health Survey. The composite score was calculated by summing standardized scores for each individual psychoneurological symptom. In contrast, reduced rank regression weighted the individual symptoms using their respective associations with mothers' function; the weighted individual symptom scores were summed into the reduced rank regression symptom score. RESULTS:The composite score and reduced rank regression score were highly correlated at .93. The cluster of psychoneurological symptoms accounted for 53.7% of the variation in the mothers' function. Depressed mood and pain accounted for almost all the explained variation in mothers' function at 37.2% and 15.0%, respectively. DISCUSSION:The composite score approach was simpler to calculate, and the high correlation with the reduced rank regression score indicates that the composite score reflected most of the variation explained by the reduced rank regression approach in this data set. However, the reduced rank regression analysis provided additional information by identifying pain and depressed mood as having the strongest association with a mother's function, which has implications for understanding which symptoms to target in future interventions. Future studies should also explore composite versus reduced rank regression approaches given that reduced rank regression may yield different insights in other data sets.

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Friedewald's equation for calculating LDL-cholesterol: Is it the time to say "Goodbye" and adopt direct LDL cholesterol methods?

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Friedewald's equation for calculating LDL-cholesterol: Is it the time to say "Goodbye" and adopt direct LDL cholesterol methods?

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