title: [Comparison of calculated LDL cholesterol (LDL-C) versus measured LDL cholesterol (LDL-M) and potential impact in terms of therapeutic management].
abstract: LDL-cholesterol value is one of the criteria used by the Haute autorité de santé (HAS) in the management of patients in primary and secondary prevention with the aim to reduce cardiovascular mortality. In this respect, the recommendations have been established based on target to achieve LDL-cholesterol. Currently in France, the determination of LDL-cholesterol is mainly carried out by the Friedewald formula whose limits are well known. However, reliable methods for the determination of LDL-cholesterol exist. We compared the results of calculated and measured LDL-cholesterol obtained from 444 patients presenting normal triglyceridemia values in terms of ranking relative to the thresholds of the HAS. The correlation between the two methods is quite good, but a significant difference (p <0.0001) was observed between the calculated and measured values of LDL-cholesterol. On the other hand in 17% of cases the classification of subjects will be different, with a majority so overestimation of calculated LDL-cholesterol with respect to measured LDL-cholesterol. This overestimation is not proportional, in fact most values measured LDL-cholesterol, the higher the calculate-measured difference is important. The rating difference is particularly important when subjects have between 1 and 3 factors of cardiovascular risk where the target LDL-cholesterol to achieve is between 1.3 and 1.9 g/L. The management of patients with lipid lowering may potentially be dependent on the method used for the determination of LDL-cholesterol.
authors.affiliation: Laboratoire de biochimie, Hôpital G&R, Laennec Centre hospitalier et universitaire de Nantes, Saint-Herblain, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Reignier
authors.affiliation: Laboratoire de biochimie, Hôpital G&R, Laennec Centre hospitalier et universitaire de Nantes, Saint-Herblain, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Sacchetto
authors.affiliation: Biostatistiques, pharmacoépidémiologie et mesures subjectives en santé, Université de Nantes, UFR des sciences pharmaceutiques et biologiques, Nantes, France.
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: Hardouin
authors.affiliation: Laboratoire de biochimie, Hôpital G&R, Laennec Centre hospitalier et universitaire de Nantes, Saint-Herblain, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Orsonneau
authors.affiliation: Laboratoire de biochimie, Hôpital G&R, Laennec Centre hospitalier et universitaire de Nantes, Saint-Herblain, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Le Carrer
authors.affiliation: Laboratoire de biochimie, Hôpital G&R, Laennec Centre hospitalier et universitaire de Nantes, Saint-Herblain, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Delaroche
authors.affiliation: Laboratoire de biochimie, Hôpital G&R, Laennec Centre hospitalier et universitaire de Nantes, Saint-Herblain, France.
authors.forename: Edith
authors.initials: E
authors.lastname: Bigot-Corbel
mesh_terms: D008078:Cholesterol, LDL / Q000097:blood*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy
chemical_list: D008078:Cholesterol, LDL
keywords: Friedewald formula; HAS recommendations; calculated LDL-cholesterol; measured LDL-cholesterol