Comparison of two methods of estimation of low density lipoprotein cholesterol, the direct versus friedewald estimation |
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| Authors: | Suchanda Sahu MBBS MD Rajinder Chawla Bharti Uppal |
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| Institution: | (1) Dept. of Biochemistry, Christian Medical College, 141 008 Ludhiana, Punjab, India |
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| Abstract: | Current recommendations of the Adult Treatment Panel and Adolescents Treatment Panel of National Cholesterol Education Program
make the low-density lipoprotein cholesterol (LDL-C) levels in serum the basis of classification and management of hypercholesterolemia.
A number of direct homogenous assays based on surfactant/solubility principles have evolved in the recent past. This has made
LDL-C estimation less cumbersome than the earlier used methods. Here we compared one of the direct homogenous assays with
the widely used Friedewald’s method of estimation of LDL-C to see the differences and correlation. We used direct homogenous
assay kit to estimate serum LDL-C and high-density lipoprotein cholesterol (HDL-C). Serum Triglyceride (TG) and Total Cholesterol
(TC) was estimated and using Friedewald’s formula LDL-C was calculated. The LDL-C level obtained by both methods in 893 fasting
serum samples were compared. The statistical methods used were paired t-test and Pearson’s correlation.
There was significant difference in the mean LDL-C levels obtained by the two methods at the TG levels <200 mg/dl (p<0.02)
and TC levels >150 mg% (p<0.001). The correlation coefficient (r) between Friedewald’s and direct assay estimation was 0.88.
Friedewald’s method classified 23.5 % of patients as high cardiac risk whereas there were 17.58% by direct assay.
Both had good correlation even though the serum triglyceride and total cholesterol levels affect the difference in LDL-C estimated
by both methods. Taking into account the cost and performance, Friedewald’s method is as good or even better for classifying
and managing patients. |
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| Keywords: | Direct assay Friedewald’ s method High-density lipoprotein cholesterol (HDL-C) Low-density lipoprotein cholesterol (LDL-C) Triglyceride (TG) Total cholesterol (TC) |
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