Validation of multiple equations for estimating low-density lipoprotein cholesterol levels in Korean adults
- PMID: 34544435
- PMCID: PMC8453999
- DOI: 10.1186/s12944-021-01525-6
Validation of multiple equations for estimating low-density lipoprotein cholesterol levels in Korean adults
Abstract
Background: Limited data are available for validation of low-density lipoprotein cholesterol (LDL) calculation (LDLcal) in the adult Korean population. The aim of this study was to develop and validate a new equation for LDLcal and to compare it with previous such equations in a Korean population.
Methods: A new equation for LDLcal was developed (LDLChoi). LDLChoi and 11 other previously published equations were applied and compared with directly measured LDL concentration (LDLdirect) in a development cohort (population 1), an independent validation cohort in the same laboratory (population 2), and the Korea National Health and Nutrition Examination Survey 2017 cohort (population 3).
Results: Among the 12 equations, the newly-developed equation (LDLChoi = total cholesterol - 0.87 x high-density lipoprotein cholesterol - 0.13 x triglycerides) had the highest intraclass correlation coefficient (ICC) and the lowest mean systemic difference and median absolute percentage error in populations 1 and 2 but not in population 3. Subgroup analysis showed good agreement between LDLChoi and LDLdirect (ICC > 0.75) in population 2, whose LDLdirect < 70 mg/dL. For samples with high triglycerides (> 400 mg/dL), equation accuracy varied. Categorization concordance according to the National Cholesterol Education Program Adult Treatment Panel III criteria with the other 11 equations were less than 80%; that of LDLChoi was 87.6 and 87.4% in populations 1 and 2, respectively.
Conclusions: Accuracy of 12 equations for LDLcal varied by cohort and subgroup based on LDLdirect and triglycerides. A laboratory-specific equation for LDLcal and/or LDLdirect may be needed for accurate evaluation of LDL status.
Keywords: Calculated low-density lipoprotein; Friedwald equation; Korea; Low-density lipoprotein cholesterol; Martin/Hopkins equation; National Cholesterol Education Program.
© 2021. The Author(s).
Conflict of interest statement
No potential conflicts of interest relevant to this article were reported.
Figures
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