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Comparison common equations for LDL-C calculation with direct assay and developing a novel formula in Iranian
Fatemeh Molavi1, Nazli Namazi2, Mojgan Asadi3
1Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
The Friedwald method is the most accurate for estimating LDL-C in Iranian children and adolescents, with a new formula showing high specificity. This research is crucial for early dyslipidemia diagnosis.
Area of Science:
- Pediatric Endocrinology
- Clinical Chemistry
- Public Health
Background:
- Hypercholesterolemia and dyslipidemia are prevalent in children, increasing atherosclerosis risk.
- Early detection of dyslipidemia in pediatric populations is essential.
- Current laboratory methods for low-density lipoprotein cholesterol (LDL-C) are often unavailable or uneconomical, necessitating reliable estimation formulas.
Purpose of the Study:
- To assess the precision of different formulas for estimating LDL-C in Iranian children and adolescents.
- To compare the accuracy of the Friedwald method and a newly developed formula against direct LDL-C measurements.
- To identify the most suitable method for routine lipid profile assessment in this age group.
Main Methods:
- Utilized data from the Caspian V study (2015) involving 7-18-year-old students across Iran.
- Measured total cholesterol (TC), HDL, LDL, and triglycerides (TG) using standard laboratory techniques.
- Calculated LDL-C using the Friedwald equation, a new formula, and compared results with direct assays.
Main Results:
- The Friedwald equation demonstrated the highest accuracy in estimating LDL-C concentrations among Iranian children and adolescents compared to four other common formulas.
- A newly introduced formula was found to be the second most accurate.
- The strongest correlation between the Friedwald and new formulas was observed in the 15-18-year-old age group.
Conclusions:
- The Friedwald equation showed the strongest correlation with direct LDL-C assays, particularly when triglyceride levels were below 100 mg/dL.
- The newly developed formula exhibited the highest specificity (98.9%) for LDL-C estimation.
- The Anandraja equation offered the highest sensitivity (89.5%), highlighting the varying performance of different formulas based on specific lipid parameters.
Background:
Hypercholesterolemia is a common dyslipidemia that leads to atherosclerosis. It is proved that early stages of atherosclerosis begins in early stages of life. In several studies, widespread prevalence of dyslipidemia in children is reported. So, assessment of lipid profile in children and adolescence is necessary for early diagnosis of dyslipidemia. Laboratory methods for measuring LDL are not available and economical. So, in some laboratories Friedwald method is used to determine LDL level. But, the preciseness of this method is not acceptable. Further, the preciseness of this method was not assayed in children and adolescence. So, it seems that assaying the preciseness of different methods is necessary.
Methods:
The methodology of this work is on the basis of findings of the Caspian V study. This study was conducted in 30 provinces of Iran during 2015. The population of this work was rural and urban students aged 7-18 years old. The level of total cholesterol (TC), HDL, LDL, and TG were measured using laboratory methods. The average and variances values were determined for each group of data using SPSS. Further, LDL values were calculated with a new formula introduced in this work. A comparison was made between the new formula and the other methods.
Results:
In the present study, we found that compare to four common formulas, Friedwald was the best equation to estimate LDL-C concentrations in Iranian children and adolescents and the new formula was the next accurate equation. The strongest correlation between Friedwald and the new equation was found for those with 15-18 years old.
Conclusion:
Considering the cut-off points of TG (100 mg/dL), we observed the strongest correlation between Friedwald equation and direct assay and the weakest one was for Ahmadi formula in subjects with either greater or lower TG concentrations. Furthermore, we found that Anandraja equation had the most sensitivity (89.5%), while the most specificity was dedicated to the new formula (98.9%).
