Comparison of Methods to Estimate Low-Density Lipoprotein Cholesterol in Patients With High Triglyceride Levels

Abstract

IMPORTANCE Low-density lipoprotein cholesterol (LDL-C) is typically estimated with the Friedewald or Martin/Hopkins equation; however, if triglyceride levels are 400 mg/dL or greater, laboratories reflexively perform direct LDL-C (dLDL-C) measurement. The use of direct chemical LDL-C assays and estimation of LDL-C via the National Institutes of Health Sampson equation are not well validated, and data on the accuracy of LDL-C estimation at higher triglyceride levels are limited. OBJECTIVE To compare an extended Martin/Hopkins equation for triglyceride values of 400 to 799 mg/dL with the Friedewald and Sampson equations. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study evaluated consecutive patients at clinical sites across the US with patient lipid distributions representative of the US population in

Remnant cholesterol is associated with cardiovascular mortality

“…The new Sampson formula reported by Sampson et al is a better alternative for estimating LDL-C than conventional methods ( 18 ). Quite a few studies proved that Sampson's formula is more accurate than Friedewald's formula, even when TG is above 800 mg/dL ( 45 , 46 ). Given the above reasons, it is reasonable to estimate RC using the Sampson formula.…”

How should low-density lipoprotein cholesterol be calculated in 2022?

“…Sajja et al [28] concluded that the Martin/Hopkins equation offers higher LDL-C accuracy than the Sampson equation in patients with high TG levels within the range of 4.5−9 mmol/l. In a study carried out in a group of 6701 healthy patients, Cao et al [29] support the replacement of the Friedewald equation with either the Martin-Hopkins or Sampson formula in the general population as the Martin-Hopkins and Sampson formulae did not over or underestimate ASCVD (atherosclerotic cardiovascular disease) Srisk.…”

“…Sajja et al [28] concluded that the Martin/ Hopkins equation offers higher LDL-C accuracy than the Sampson equation in patients with high TG levels within the range of 4.5À9 mmol/l. In a study carried out in a group of 6701 healthy patients, Cao et al [29] support the replacement of the Friedewald equation with either the Martin-Hopkins or Sampson formula in the general population as the Martin-Hopkins and The difference between the correlation coefficients was statistically significant Good correlation was also seen with LDL-C levels <1mmol/l as seen in patients on PCSK9 inhibitors When TG levels are >1.7 mmol/l which occurs in the top 25--30% of the population, the NIH Eq.…”

Friedewald, Martin/Hopkins ou Sampson/NIH: Qual o Melhor Método para Estimar o LDL-Colesterol?

“…Importantly, a nonfasting state did not change the performance of the Martin/Hopkins method but reduced the accuracy of the Sampson/NIH formula. 14 In another work, the authors demonstrated clinically meaningful differences in LDL-c calculated by different formulas in patients with ASCVD. LDL-c was usually higher with the Martin/Hopkins equation, suggesting a higher rate of LDL-c underestimation with the Friedewald and Sampson/NIH methods.…”

“…In this sense, evidence from two large databases using directly measured LDL-c as the comparator favored the Martin/Hopkins approach, 11,12 whereas a smaller study found that the Sampson/NIH formula had higher concordance with LDL-c estimated using VLDL-c measured by ultracentrifugation in individuals with familial combined hyperlipidemia. 13 Two recent studies published by Sajja et al 14,15 from Johns Hopkins University have raised concerns about the Sampson/NIH method. In one of them, the authors showed that an extended version of the Martin/Hopkins equation had better accuracy than the Friedewald and Sampson/ NIH formulas in individuals with TG levels of 400 to 799 mg/dL.…”