title: The impact of low serum triglyceride on LDL-cholesterol estimation.
abstract: Most clinical laboratories directly measure serum triglyceride, total cholesterol, and high- density lipoprotein cholesterol. They indirectly calculate low-density lipoprotein cholesterol value using the Friedewald equation. Although high serum triglyceride (>400 mg/dL or 4.52 mmol/L) devaluates low-density lipoprotein cholesterol calculation by using this formula, effects of low serum triglyceride (<100 mg/dL or 1.13 mmol/L) on its accuracy is less defined.Two hundred thirty serum samples were assayed during a one-year period. In 115 samples, the triglyceride level was below 100 mg/dL and in 115 samples from age- and sex-matched patients the triglyceride level was 150 - 350 mg/dL (1.69 - 3.95 mmol/L). In both groups total cholesterol was above 250 mg/dL (6.46 mmol/L). On each sample, total cholesterol, high-density lipoprotein cholesterol, and triglyceride were directly measured in duplicate and low-density lipoprotein cholesterol measured directly and calculated with Friedewald equation as well. Statistical analysis showed that when triglyceride is <100 mg/dL, calculated low- density lipoprotein cholesterol is significantly overestimated (average :12.17 mg/dL or 0.31 mmol/L), where as when triglyceride is between 150 and 300 mg/dL no significant difference between calculated and measured low-density lipoprotein cholesterol is observed. In patients with low serum triglyceride and undesirably high total cholesterol levels, Friedewald equation may overestimate low-density lipoprotein cholesterol concentration and it should be either directly assayed or be calculated by a modified Friedewald equation. Using linear regression modeling, we propose a modified equation.
authors.affiliation: Department of Pathology, Sina Hospital, Medical Sciences/ University of Tehran, Tehran, Iran. ahmadise@tums.ac.ir
authors.forename: Seyed-Ali
authors.initials: SA
authors.lastname: Ahmadi
authors.forename: Mohammad-Ali
authors.initials: MA
authors.lastname: Boroumand
authors.forename: Katayoun
authors.initials: K
authors.lastname: Gohari-Moghaddam
authors.forename: Parvin
authors.initials: P
authors.lastname: Tajik
authors.forename: Seyed-Mohammad
authors.initials: SM
authors.lastname: Dibaj
mesh_terms: D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*
chemical_list: D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol