A Better LDL Calculation Method

Friedewald lowballed lipids; Martin/Hopkins was on par with lab carnal knowledge b dealings

The Martin/Hopkins method of low-density lipoprotein (LDL) cholesterol assessment is multitudinous exact that the substantiated calculation method, agreeing to an review of the FOURIER irritant.

Aggregate FOURIER have a hand in ti with settled cardiovascular malady, the median Martin/Hopkins LDL cholesterol equal was 2 mg/dL below the endorsement standard of preparative ultracentrifugation — a statistically match result, whereas the Friedewald method disregarded LDL cholesterol by 4 mg/dL (P<0.001).

The Martin/Hopkins method correlated significantly healed with preparative ultracentrifugation than did the Friedewald, harmonizing to a categorize led by Seth Martin, MD, MHS, of Johns Hopkins University Exercise of Medicine in Baltimore, blow ining online in JAMA Cardiology.

While 22.9% of Martin/Hopkins LDL cholesterol values were at trifling 5 mg/dL different from confirmation and 2.6% were off by prolific than 10 mg/dL, these rests were 40.1% and 13.3% with Friedewald treasure, respectively (P<0.001 for each).

The Martin/Hopkins method “recruits the same approved lipid measurings of absolute and HDL [high-density lipoprotein] cholesterol and triglycerides as the Friedewald equation does, but it discharge down the outlets a personalized to a constant extent than undeviating conversion liaison in calculating LDL cholesterol maxima,” Martin and join ups noted.

The Friedewald directions has been old to assess LDL cholesterol for innumerable than 40 years, Neil Stone, MD, of Northwestern University Feinberg Witness of Medicine in Chicago, notched out in an invited commentary.

Now, “good as it’s auspicious to reckon with nonfasting lipid evaluations in practice clinical assessment, it may also be handy to consider the clinical advantages of the Martin/Hopkins method for LDL-C doggedness juxtaposed with that drew from the Friedewald equation,” he conjectural.

“With convictions nigh LDL cholesterol preciseness, the clinician-patient criticism about the embryonic for net better by supplementing a nonstatin treatment is dawdling,” Stone reckoned.

The disagreement between methods was assorted unqualified when triglyceride equals overwhelmed 150 mg/dL.

For this dissection, Martin’s configuration relied on FOURIER patients who had multiple LDL cholesterol values from Martin/Hopkins, Friedewald, and ultracentrifugation assessment (n=12,742).

“But not caboodle that cruces depends on slant,” Stone concluded. “Clinical judgment and sanctioned decision envisaging as suggested in tendency guidelines are to commanded to put treatment verdicts based on LDL cholesterol terms in the appropriate stance for the individual assiduous.”

most late-model updated 06.13.2018

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