Method to estimate LDL-C may provide more accurate risk classification

November 17, 2013

Seth S. Martin, M.D., of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, and colleagues developed a method for estimating low-density lipoprotein cholesterol (LDL-C) levels that is more accurate than the standard measure.

Low-density lipoprotein cholesterol is the primary target for treatment in national and international clinical practice guidelines. Conventionally, LDL-C is estimated by the Friedewald equation, which estimates LDL-C as (total cholesterol) - (high-density lipoprotein cholesterol [HDL-C]) - (triglycerides/5) in mg/dL. The final term assumes a fixed ratio of to very low-density lipoprotein (TG:VLDL-C) of 5:1. "Applying a factor of 5 to every individual patient is problematic given variance in the TG:VLDL-C ratio across the range of and non-HDL-C levels," according to background information in the study.

The researchers used a sample of lipid profiles obtained from 2009 through 2011 from 1,350,908 children, adolescents, and adults in the United States.

From this large sample of , the authors created and validated a novel method to estimate LDL-C from the standard lipid profile, consisting of a 180-cell table (grid) of median TG:VLDL-C values based on triglyceride and non-HDL-C values. Rather than assuming a fixed factor of 5, it applies an adjustable factor for the TG:VLDL-C ratio based on triglyceride and non-HDL-C concentrations. "The greatest advantage occurs in classification of LDL-C concentrations lower than 70 mg/dL, especially in patients with elevated triglyceride concentrations. In addition to the novel analytic approach, a major strength of this study is its size, 3,015 times larger than the original Friedewald database."

"These findings require external validation, as well as assessment of their clinical importance. The novel method could be easily implemented in most laboratory reporting systems at virtually no cost."

Explore further: Cinnamon cuts blood glucose levels in diabetes patients

More information: JAMA doi:10.l001/jama.2013.280532

Related Stories

Cinnamon cuts blood glucose levels in diabetes patients

September 16, 2013
(HealthDay)—Consumption of cinnamon is associated with favorable reductions in plasma glucose and lipid levels, according to research published in the September/October issue of the Annals of Family Medicine.

Commonly used cholesterol calculation underestimates heart disease danger for many

March 26, 2013
In what promises to be an eye-opener for many doctors and patients who routinely depend on cholesterol testing, a study led by researchers at the Johns Hopkins University School of Medicine found that the standard formula ...

Cholesterol levels improving among US adults

October 16, 2012
An analysis of nationally-representative data indicates that between 1988 and 2010 there has been a trend of declining average levels of total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein ...

Cholesterol levels appear to be improving among US youths

August 7, 2012
In a study involving more than 16,000 U.S. children and adolescents, there has been a decrease in average total cholesterol levels over the past 2 decades, although almost 1 in 10 had elevated total cholesterol in 2007-2010, ...

Cholesterol levels rise, fall with changing seasons

March 7, 2013
Cholesterol levels seem to fluctuate significantly with the turning seasons, which may leave some people with borderline high cholesterol at greater cardiovascular risk during the winter months, according to research being ...

Low HDL-cholesterol—Not quantity, but quality

April 30, 2013
Many of the genes regulating the inflammation and immune response of the body are also associated with low HDL-cholesterol levels in the circulation, tells the recent study conducted at the University of Helsinki, Finland. ...

Recommended for you

Molecular hitchhiker on human protein signals tumors to self-destruct

July 24, 2017
Powerful molecules can hitch rides on a plentiful human protein and signal tumors to self-destruct, a team of Vanderbilt University engineers found.

Researchers develop new method to generate human antibodies

July 24, 2017
An international team of scientists has developed a method to rapidly produce specific human antibodies in the laboratory. The technique, which will be described in a paper to be published July 24 in The Journal of Experimental ...

New vaccine production could improve flu shot accuracy

July 24, 2017
A new way of producing the seasonal flu vaccine could speed up the process and provide better protection against infection.

A sodium surprise: Engineers find unexpected result during cardiac research

July 20, 2017
Irregular heartbeat—or arrhythmia—can have sudden and often fatal consequences. A biomedical engineering team at Washington University in St. Louis examining molecular behavior in cardiac tissue recently made a surprising ...

Want to win at sports? Take a cue from these mighty mice

July 20, 2017
As student athletes hit training fields this summer to gain the competitive edge, a new study shows how the experiences of a tiny mouse can put them on the path to winning.

'Smart' robot technology could give stroke rehab a boost

July 19, 2017
Scientists say they have developed a "smart" robotic harness that might make it easier for people to learn to walk again after a stroke or spinal cord injury.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.