Oliveira M.J.A., van Deventer H.E., Bachmann L.M., Warnick G.R., Nakajima K., Nakamura M., Sakurabayashi I., Kimberly M.M., Shamburek R.D., Korzun W.J., Myers G.L., Miller W.G., Remaley A.T.
Department of Laboratory Medicine, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, United States; Lancet Laboratories, PO Box 37918, Faerie Glen, Pretoria, 0043, South Africa; Department of Pathology, Virginia Commonwealth University, 1111 West Broad Street, Richmond, VA 23284, United States; Health Diagnostic Laboratory, 737 North 5th Street, Suite 103, Richmond, VA 23219, United States; Nakajima and Associates, Co., 201 Nakajima Bldg., 3-33-2 Minami-cho, Maebashi, Guma, 371-0805, Japan; Osaka Medical Center for Health Science and Promotion, Department of Health Promotion and Education, 1-3-2 Nakamichi, Higashinari-ku, Osaka, 537-0025, Japan; Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan; American Association for Clinical Chemistry, 1850 K Street, NW Suite 625, Washington, DC, United States
Oliveira, M.J.A., Department of Laboratory Medicine, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, United States; van Deventer, H.E., Lancet Laboratories, PO Box 37918, Faerie Glen, Pretoria, 0043, South Africa; Bachmann, L.M., Department of Pathology, Virginia Commonwealth University, 1111 West Broad Street, Richmond, VA 23284, United States; Warnick, G.R., Health Diagnostic Laboratory, 737 North 5th Street, Suite 103, Richmond, VA 23219, United States; Nakajima, K., Nakajima and Associates, Co., 201 Nakajima Bldg., 3-33-2 Minami-cho, Maebashi, Guma, 371-0805, Japan; Nakamura, M., Osaka Medical Center for Health Science and Promotion, Department of Health Promotion and Education, 1-3-2 Nakamichi, Higashinari-ku, Osaka, 537-0025, Japan; Sakurabayashi, I., Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan; Kimberly, M.M.; Shamburek, R.D., Department of Laboratory Medicine, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, United States; Korzun, W.J., Department of Pathology, Virginia Commonwealth University, 1111 West Broad Street, Richmond, VA 23284, United States; Myers, G.L., American Association for Clinical Chemistry, 1850 K Street, NW Suite 625, Washington, DC, United States; Miller, W.G., Department of Pathology, Virginia Commonwealth University, 1111 West Broad Street, Richmond, VA 23284, United States; Remaley, A.T., Department of Laboratory Medicine, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, United States
Background: Low-density lipoprotein cholesterol (LDL-C) is often calculated (cLDL-C) by the Friedewald equation, which requires high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Because there have been considerable changes in the measurement of HDL-C with the introduction of direct assays, several alternative equations have recently been proposed. Methods: We compared 4 equations (Friedewald, Vujovic, Chen, and Anandaraja) for cLDL-C, using 8 different direct HDL-C (dHDL-C) methods. LDL-C values were calculated by the 4 equations and determined by the β quantification reference method procedure in 164 subjects. Results: For normotriglyceridemic samples (TG < 200 mg/dl), between 6.2% and 24.8% of all results exceeded the total error goal of 12% for LDL-C, depending on the dHDL-C assay and cLDL-C equation used. Friedewald equation was found to be the optimum equation for most but not all dHDL-C assays, typically leading to less than 10% misclassification of cardiovascular risk based on LDL-C. Hypertriglyceridemic samples (>200 mg/dl) showed a large cardiovascular risk misclassification rate (30%-50%) for all combinations of dHDL-C assays and cLDL-C equations. Conclusion: The Friedewald equation showed the best performance for estimating LDL-C, but its accuracy varied considerably depending on the specific dHDL-C assay used. None of the cLDL-C equations performed adequately for hypertriglyceridemic samples. © 2013.