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Evaluation of a new equation for estimating low-density lipoprotein cholesterol through the comparison with various recommended methods
Authors:Eduardo Martínez-Morillo  María García-García  María Angeles Luengo Concha  Luis Rello Varas
Institution:1.Department of Clinical Biochemistry, Hospital Universitario Miguel Servet, Zaragoza, Spain;2.Department of Clinical Biochemistry, Hospital del Oriente de Asturias, Arriondas, Asturias, Spain
Abstract:IntroductionThe accurate estimation of low-density lipoprotein cholesterol (LDL) is crucial for management of patients at risk of cardiovascular events due to dyslipidemia. The LDL is typically calculated using the Friedewald equation and/or direct homogeneous assays. However, both methods have their own limitations, so other equations have been proposed, including a new equation developed by Sampson. The aim of this study was to evaluate Sampson equation by comparing with the Friedewald and Martin-Hopkins equations, and with a direct LDL method.Materials and methodsResults of standard lipid profile (total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL) and triglycerides (TG)) were obtained from two anonymized data sets collected at two laboratories, using assays from different manufacturers (Beckman Coulter and Roche Diagnostics). The second data set also included LDL results from a direct assay (Roche Diagnostics). Passing-Bablok and Bland-Altman analysis for method comparison was performed.ResultsA total of 64,345 and 37,783 results for CHOL, HDL and TG were used, including 3116 results from the direct LDL assay. The Sampson and Friedewald equations provided similar LDL results (difference ≤ 0.06 mmol/L, on average) at TG ≤ 2.0 mmol/L. At TG between 2.0 and 4.5 mmol/L, the Sampson-calculated LDL showed a constant bias (- 0.18 mmol/L) when compared with the Martin-Hopkins equation. Similarly, at TG between 4.5 and 9.0 mmol/L, the Sampson equation showed a negative bias when compared with the direct assay, which was proportional (- 16%) to the LDL concentration.ConclusionsThe Sampson equation may represent a cost-efficient alternative for calculating LDL in clinical laboratories.
Keywords:cholesterol  equation  evaluation  low-density lipoprotein  triglycerides
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