Comparison of Low-Density Lipoprotein Cholesterol Concentrations by Direct Measurement and by Friedewald Calculation
Comparison of Low-Density Lipoprotein Cholesterol Concentrations by Direct Measurement and by Friedewald Calculation
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DOI：
10.1016/j.amjcard.2019.12.036
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发表时间：
2020-03-15
影响因子：
2.8
通讯作者：
Shin, Jeong-Hun
中科院分区：
文献类型：
--
作者：
Sung, Ki-Chul;Kwon, Chang Hee;Shin, Jeong-Hun
本研究的目的是比较 Friedewald 计算的和直接测量的低密度脂蛋白胆固醇 (LDL-C) 水平。临床实践中，LDL-C常规采用Friedewald公式估算。然而，Friedewald 计算的 LDL-C 在 LDL-C 水平较低或甘油三酯水平较高时出现不可靠性。我们对 2017 年接受全面健康检查的 147,143 名韩国成年人进行了检查。排除计算出的 Friedewald LDL-C = 400 mg/dL 的受试者后，对 145,043 名受试者（女性；43%，平均年龄；42 +/- 8）进行了分析。 Friedewald 计算的 LDL-C 水平比直接测量的 LDL-C 低约 15 mg/dL。 Friedewald 测量对所有甘油三酯水平中直接测量的 LDL-C 截止值 >= 100 mg/dL 具有很高的敏感性（男性敏感性为 79.2%、82.2%，女性敏感性为 74.5%）和特异性（100%）。在 82% 的受试者中，两种方法测量的 LCL-C 相差超过 10 mg/dL。对于国家胆固醇教育计划风险类别，两种方法之间重新分类的比例为 50.3%，Friedewald 测量 LDL-C = 70 mg/dL 的患者。 LDL-C 水平的直接测量和 Freidewald 测量具有良好的相关性。然而，两种方法的一致性较低，并且对于 NECP 风险类别，两种方法之间的重新分类非常重要。因此，有必要就 LDL-C 测量达成全球共识。 (C) 2019 年由爱思唯尔公司出版
The purpose of this study was to compare Friedewald-calculated and directly measured low-density lipoprotein cholesterol (LDL-C) levels. LDL-C is routinely estimated by the Friedewald formula in clinical practice. However, unreliability of the Friedewald-calculated LDL-C appears at lower LDL-C level or high triglyceride levels. We examined 147,143 Korean adults who underwent a comprehensive health examination in 2017. After excluding subjects with calculated Friedewald LDL-C = 400 mg/dL, 145,043 subjects (female; 43%, mean age; 42 +/- 8) were analyzed. Friedewald-calculated LDL-C levels were approximately 15 mg/dL lower to directly measured LDL-C. Friedewald measurement had high sensitivity (79.2%, 82.2% of sensitivity in males and 74.5% of sensitivity in females) and specificity (100%) for directly measured LDL-C cut-off value of >= 100 mg/dL in all levels of triglyceride. In 82% of total subjects, LCL-C measured by both methods differed by more than 10 mg/dL. The proportion of reclassification between both methods for National Cholesterol Education Program categories of risk was 50.3% of patients with Friedewald measurement of LDL-C = 70 mg/dL. Direct and Freidewald measurements of LDL-C levels are well correlated. However, concordance of both methods is low and reclassification between both is substantial for NECP categories of risk. Thus, it is desirable to make a global consensus on the LDL-C measurement. (C) 2019 Published by Elsevier Inc.