A Clinical Comparison of Calculated versus Direct Measurement of Low-Density Lipoprotein Cholesterol Level

Study Objectives. To determine if, and to what extent, the low‐density lipoprotein cholesterol (LDL) level is underestimated when it is calculated by the Friedewald formula compared with the LDL level measured by a direct method. A secondary objective was to determine and compare the percentages of...

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Bibliographic Details
Published in:Pharmacotherapy 2004-02, Vol.24 (2), p.167-172
Main Authors: Lindsey, Cameron C., Graham, Maqual R., Johnston, Thomas P., Kiroff, Chelsea G., Freshley, Anna
Format: Article
Language:English
Subjects:
Aged
Blood Chemical Analysis - methods
cholesterol
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Decision Support Techniques
Demography
Female
Friedewald formula
Humans
low-density lipoprotein cholesterol
Middle Aged
Randomized Controlled Trials as Topic
Retrospective Studies
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Summary:Study Objectives. To determine if, and to what extent, the low‐density lipoprotein cholesterol (LDL) level is underestimated when it is calculated by the Friedewald formula compared with the LDL level measured by a direct method. A secondary objective was to determine and compare the percentages of patients meeting LDL goal using each of these two methods. Design. Retrospective chart review. Setting. Kansas City Veterans Affairs Medical Center. Subjects. Patients aged 18 years or older and whose laboratory results reflected a complete lipid profile for 1 year. Measurement and Main Results. Calculated LDL level (C‐LDL) was derived using the Friedewald formula and was compared with Wako method–derived direct LDL level (D‐LDL) to ascertain whether a positive correlation existed. The absolute difference between the methods for each sample was determined and compared overall and for various subgroups. The number of patient samples achieving National Cholesterol Education Program–defined LDL goal was determined and compared for both methods. A total of 20,224 lipid profiles were generated and 19,343 were included in the analysis. A strong correlation was found between D‐LDL and C‐LDL (r = 0.94). The absolute difference between the two methods demonstrated an underestimation of C‐LDL of 19.5 ± 11.8 mg/dl. The degree of underestimation increased as the triglyceride level increased (p
ISSN:0277-0008
1875-9114
DOI:10.1592/phco.24.2.167.33142