Friedewald's formula is the most frequently used formula for the calculation of serum lowdensity lipoprotein cholesterol from serum total cholesterol, serum triacylglycerol and serum high-density lipoprotein cholesterol. Most laboratories use serum triacylglycerol concentration of 400 mg/dl as upper cut-off limit for the calculation of LDL cholesterol, but a combination of serum triacylglycerol to total cholesterol ratio and serum triacylglycerol may have more advantages than serum triacylglycerol concentration alone to use Friedewald's formula effectively. The aim of this study was to determine the upper cut-off limit of serum triacylglycerol concentration and serum triacylglycerol to total cholesterol ratio to calculate LDL cholesterol using Friedewald's formula in Bangladeshi population. Serum total cholesterol, serum triacylglycerol, serum high-density lipoprotein cholesterol and serum lowdensity lipoprotein cholesterol were measured by direct method on 644 sera obtained from adult Bangladeshi study subjects after 12 hours of fasting. Serum low-density lipoprotein cholesterol was also calculated by using Friedewald formula. Low-density lipoprotein cholesterol obtained by Friedewald's formula in this study was compared with that obtained by direct method in different level of triacylglycerol and also in different triacylglycerol to total cholesterol ratio. Friedewald's formula underestimates low-density lipoprotein cholesterol when serum triacylglycerol concentration >300 mg/dL. But when direct serum low-density lipoprotein cholesterol was compared with low-density lipoprotein cholesterol calculated using Friedewald's formula up to serum triacylglycerol to total cholesterol ratio of 2, underestimation subsides, and the serum triacylglycerol level up to 700 mg/dl could be confidently included for the calculation of low-density lipoprotein cholesterol by Friedewald's formula. Friedewald's calculation formula can be confidently used up to serum triacylglycerol concentration of 700 mg/dl in Bangladeshi population, provided the serum triacylglycerol to total cholesterol ratio is two or less.

Association of fasting plasma glucose (FPG) and post prandial plasma glucose (PPG) on hemoglobin glycation is still controversial. In this study we aimed to assess the influence of FPG and PPG on hemoglobin glycation in newly diagnosed never treated diabetic (NDNT-DM) subjects and treated diabetic (T-DM) subjects. One hundred and seventy seven diabetic subjects were included in this study. Plasma glucose concentrations were measured by hexokinase end point technique and glycated hemoglobin (HbA1c) levels were measured by modified cationexchange high performance liquid chromatography (HPLC). Univariate and multivariate linear regression models were applied to assess the relative contribution of FPG and PPG on HbA1c. Univariate linear regression analysis showed significant positive association of FPG and PPG with HbA1c in both groups. Multivariate regression model showed that ? (beta) value of HbA1c was 0.5528 (p<0.0001) for FPG and 0.3047 (p<0.01) for PPG in the NDNT-DM whereas 0.5509 (p<0.0001) for FPG and 0.1874 (p>0.05) for PPG in treated diabetic subjects. After adjustment for age and sex, beta remains statistically significant for FPG and PPG where beta value for FPG was higher for FPG than for PPG in both NDNT-TM group and T-DM groups. This study revealed that FPG has a stronger association on hemoglobin glycation as compared to PPG in diabetes mellitus. Anwer Khan Modern Medical College Journal Vol. 4, No. 2: July 2013, Pages 28-30 DOI: http://dx.doi.org/10.3329/akmmcj.v4i2.16939

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Glomerular filtration rate (GFR) is the filtrate produced by the kidneys in each minute. Chronic kidney disease epidemiology (CKD-EPI) and standardized modification of diet in renal disease (MDRD) equations are the commonly used equations to estimate GFR. Evaluation of GFR prediction equations regarding body mass index is not available in Bangladeshi population. In this study we compared estimated GFR (eGFR) with GFR measured by creatinine clearance rate (CCR) in lean and obese Bangladeshi subjects. Measured GFR were 40±21 and 45±22 ml/min/1.73m 2 in lean and obese groups, respectively. Compared to measured GFR, estimated GFRs were 7.5 (p<0.0001), 5.2 (p<0.0001) ml/min/1.73m 2 higher for CKD-EPI and MDRD four variables (MDRD4) equations in lean group and 6.9 (p<0.0001), 3.2 (p>0.05) ml/min/1.73 m 2 higher for CKD-EPI and MDRD4 equations in obese group. The precision (r 2 ) was 0.6461 for CKD-EPI, 0.6508 for MDRD4 equations in lean group and 0.6337 for CKD-EPI and 0.6021 for MDRD4 equations in obese group. The percentages of eGFR falling within 15% measured GFR were 37 for CKD-EPI, 52 for MDRD4 in lean group; 41 for CKD-EPI, 39 for MDRD4 in obese group. CKD-EPI equation overestimates GFR in both lean and obese, but MDRD4 equation overestimates GFR only in lean Bangladeshi subjects.

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