LDL-cholesterol measurement in diabetic type 2 patients: a comparison between direct assay and popular equations
Tóm tắt
Low density lipoprotein –Cholesterol (LDL-C) is one of the main factors for assessment of cardiovascular disease risk and it is more important in diabetic patients. Various methods are currently used for LDL-C measurements which are compared in this study. This study was conducted in Diabetes Research Center based on laboratory results of 1721 diabetic patients who referred to laboratory for regular follow-up of lipid profile. LDL-C was measured directly and also estimated according to Friedwald, Anandraja and Chen formulas. Results of direct LDL-C measurements were lower than all calculations at triglycerides (TG) levels less than 150 mg/dL while in higher TG levels direct measurement values were higher than Friedwald and Anandraja formula. Friedwald and Chen formula results had better correlation(r) with direct measurement than Anandraja in different levels of TG and also were able to define LDL-C > 100 mg/dL more accurately. Although we observed excellent correlation between the studied formulas with direct measurement, using the formula can misclassified diabetic patients with LDL-C values near threshold (100 mg/dL). However calculated LDL-C based on Chen and Friedwald formula can be a suitable alternative for direct measurement especially in regions with limited resources.
Tài liệu tham khảo
Shafiee G, Nasli-Esfahani E, Bandarian F, Peimani M, Yazdizadeh B, Razi F, et al. Iran diabetes research roadmap (IDRR): the study protocol. Journal of Diabetes & Metabolic Disorders. 2016;15(1):58.
Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. Lancet378(9785):31–40.
Atlas ID. International diabetes federation, Brussels, 2015. Available from:[Last accessed. March 2014;5:2015.
Nasli-Esfahani E, Farzadfar F, Kouhnavard M, Ghodssi-Ghassemabadi R, Khajavi A, Peimani M, et al. Iran diabetes research roadmap (IDRR) study: a preliminary study on diabetes research in the world and Iran. Journal of Diabetes & Metabolic Disorders. 2017;16(1):9.
Abrishami Z, Nasli-Esfahani E, Razmandeh R, Larijani B, Bandarian F. Iran diabetes research roadmap (Idrr) study; gap analysis of diabetes complications in iran: a review article. Iranian Journal of Public Health. 2017;46:32–8.
Peimani M, Abrishami Z, Nasli-Esfahani E, Bandarian F, Ghodsi M, Larijani B. Iran diabetes research roadmap (IDRR) study; analysis of diabetes comorbidity studies in iran: a review article. Iranian Journal of Public Health. 2017;46:39–46.
Razi F, Esfahani EN, Farzami MR, Tootee A, Qorbani M, Ebrahimi SA, et al. Effect of the different assays of HbA1c on diabetic patients monitoring. Journal of Diabetes & Metabolic Disorders. 2015;14(1):65.
Delavari A, Alikhani S, Nili S, Birjandi RH, Birjandi F. Quality of care of diabetes mellitus type II patients in Iran. Arch Iran Med. 2009;12(5):492–5.
Lorber D. Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2014;7:169–83.
Hajifathalian K, Ueda P, Lu Y, Woodward M, Ahmadvand A, Aguilar-Salinas CA, et al. A novel risk score to predict cardiovascular disease risk in national populations (Globorisk): a pooled analysis of prospective cohorts and health examination surveys. The Lancet Diabetes & Endocrinology. 2015;3(5):339–55.
Stark Casagrande S, Fradkin JE, Saydah SH, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988–2010. Diabetes Care. 2013;36(8):2271–9.
Miller WG, Myers GL, Sakurabayashi I, Bachmann LM, Caudill SP, Dziekonski A, et al. Seven direct methods for measuring HDL and LDL cholesterol compared with ultracentrifugation reference measurement procedures. Clin Chem. 2010;56(6):977–86.
Martin SS, Blaha MJ, Elshazly MB, Toth PP, Kwiterovich PO, Blumenthal RS, et al. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA. 2013;310(19):2061–8.
Mora S, Rifai N, Buring JE, Ridker PM. Comparison of LDL cholesterol concentrations by Friedewald calculation and direct measurement in relation to cardiovascular events in 27 331 women. Clin Chem. 2009;55(5):888–94.
Anandaraja S, Narang R, Godeswar R, Laksmy R, Talwar K. Low-density lipoprotein cholesterol estimation by a new formula in Indian population. Int J Cardiol. 2005;102(1):117–20.
Chen Y, Zhang X, Pan B, Jin X, Yao H, Chen B, et al. A modified formula for calculating low-density lipoprotein cholesterol values. Lipids Health Dis. 2010;9(1):52.
Rifai N, Lipids WGR. Lipoproteins. Apolipoproteins, and other cardiovascular risk factors In: Teitz textbook of clinical and Molecular Diagnostics. Philadelpia; 1999. p. 809–61.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.
Williams L. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106(25):3143.
Cordova CMMd, Schneider CR, Juttel ID, Cordova MMd. Comparison of LDL-cholesterol direct measurement with the estimate using the Friedewald formula in a sample of 10,664 patients. Arq Bras Cardiol. 2004;83(6):476–81.
de Cordova CMM, de Cordova MMA. New accurate, simple formula for LDL-cholesterol estimation based on directly measured blood lipids from a large cohort. Ann Clin Biochem. 2013;50(1):13–9.
Rubiés-Prat J, Reverter JL, Sentí M, Pedro-Botet J, Salinas I, Lucas A, et al. Calculated low-density lipoprotein cholesterol should not be used for management of lipoprotein abnormalities in patients with diabetes mellitus. Diabetes Care. 1993;16(8):1081–6.
Branchi A, Rovellini A, Torri A, Sommariva D. Accuracy of calculated serum low-density lipoprotein cholesterol for the assessment of coronary heart disease risk in NIDDM patients. Diabetes Care. 1998;21(9):1397–402.
Chai Kheng EY, Chee Fang S, Chang S, Kiat Mun SL, Su Chi L, Lee Ying Y, et al. Low-density lipoprotein cholesterol levels in adults with type 2 diabetes: an alternative equation for accurate estimation and improved cardiovascular risk classification. Diabetes and Vascular Disease Research. 2014;11(6):431–9.
Association AD. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37(Supplement 1):S14–80.
Martins J, Olorunju SA, Murray L, Pillay TS. Comparison of equations for the calculation of LDL-cholesterol in hospitalized patients. Clin Chim Acta. 2015;444:137–42.
Esteban-Salán M, Guimón-Bardesi A. De la Viuda-Unzueta JM, Azcarate-Ania MN, Pascual-Usandizaga P, Amoroto-del-Río E. Analytical and clinical evaluation of two homogeneous assays for LDL-cholesterol in hyperlipidemic patients. Clin Chem. 2000;46(8):1121–31.