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LDL-C Estimation in Ghana: A Comparative Study of 13 Calculation Methods
Samuel Asamoah Sakyi1, Linda Ahenkorah Fondjo1, Raphael Osei Mensah-Bonsu2
1Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, knust.edu.gh.
Biomed Research International
|May 28, 2026
Summary
The Sampson, Martin, and Puavilai equations are most accurate for estimating low-density lipoprotein cholesterol (LDL-C) in Ghanaians. These methods offer reliable LDL-C measurement compared to Friedewald's equation, especially across different age and lipid subgroups.
Area of Science:
- Clinical Chemistry
- Cardiovascular Health
- Population Health
Background:
- Friedewald's equation is the standard for estimating LDL-C but has accuracy limitations.
- Novel population-specific equations may offer improved accuracy.
- Evaluating LDL-C estimation equations in diverse populations is crucial.
Purpose of the Study:
- To assess the accuracy of 13 LDL-C estimation equations in the Ghanaian population.
- To compare the performance of these equations against direct LDL-C measurements.
- To identify the most reliable equations for clinical and research use in Ghana.
Main Methods:
- A cross-sectional study of 976 Ghanaian individuals.
- Lipid profiles analyzed from fasting venous blood samples.
- Direct LDL-C measured enzymatically and compared with 13 calculated equations using correlation, Bland-Altman plots, and Wilcoxon tests.
Main Results:
- All 13 equations showed significant correlation with direct LDL-C (r=0.563-0.857).
- Sampson, Martin, and Puavilai equations demonstrated strong correlations (r=0.857).
- Friedewald and Chen and Zhang equations showed adequate performance in specific subgroups (younger adults, elevated triglycerides).
Conclusions:
- Sampson, Martin, and Puavilai equations are recommended for LDL-C estimation in Ghana.
- These equations offer reliable and consistent performance across various subgroups.
- Their broader utility surpasses Friedewald and Chen and Zhang equations for Ghanaian populations.
