Low-Density Lipoprotein Estimated by Various Equations in Patients With Obesity

Area of Science:

• Cardiovascular disease prevention
• Metabolic disorders
• Clinical biochemistry

Background:

• Reducing atherogenic lipoproteins is vital for managing cardiovascular risk in obesity.
• Accurate lipid measurements guide therapy decisions and management.
• Directly measured LDL cholesterol (LDL-D) is compared against calculated values from Friedewald (LDL-F), Martin (LDL-M), and Sampson/NIH (LDL-S) equations.

Purpose of the Study:

• To identify the most accurate equation for estimating LDL cholesterol in patients with obesity.
• To evaluate the performance of different LDL calculation equations against directly measured LDL.
• To examine changes in LDL and apolipoprotein B (ApoB) during a multidisciplinary obesity treatment program.

Main Methods:

• Retrospective observational study of 308 adult patients with obesity undergoing a multidisciplinary meal replacement program.
• Statistical analyses included Pearson's correlations, repeated-measures ANOVA, and paired t-tests.
• Comparison of calculated LDL values against direct LDL measurements, assessing bias and allowable error.

Main Results:

• LDL-M and LDL-S showed less bias and better correlation with LDL-D than LDL-F.
• All tested equations (LDL-F, LDL-M, LDL-S) significantly underestimated absolute LDL values.
• LDL-D, LDL-F, LDL-M, LDL-S, and ApoB levels significantly decreased during the obesity treatment program.

Conclusions:

• LDL estimation equations consistently underestimate LDL levels in individuals with obesity.
• The Martin equation demonstrated the highest accuracy in capturing LDL changes during treatment.
• Direct LDL measurement is the preferred method, but the Martin equation is the most suitable estimation alternative. The program effectively reduced LDL cholesterol and ApoB.