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A Comparison of Methods for the Estimation of Plasma Low- and Very Low-Density Lipoprotein Cholesterol: Title and subTitle BreakThe Lipid Research Clinics Prevalence Study FREE

David M. DeLong, PhD; Elizabeth R. DeLong, PhD; Peter D. Wood, DSc; Kenneth Lippel, PhD; Basil M. Rifkind, MD
[+] Author Affiliations

Reprint requests to Lipid Metabolism-Atherogenesis Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892 (Dr Rifkind).


JAMA. 1986;256(17):2372-2377. doi:10.1001/jama.1986.03380170088024
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Using data from over 10 000 men, women, and children who participated in the Lipid Research Clinics prevalence studies, we have examined the formula adopted by Friedewald et al1 for estimating plasma or serum concentrations of low-density lipoprotein cholesterol (LDL-C) when (for economy, or in the absence of an ultracentrifuge) only fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) concentrations are measured in milligrams per liter, ie, LDL-C=TC—(HDL-C+0.20XTG). Values for LDL-C obtained by use of the Friedewald formula were compared with values derived from the Lipid Research Clinics ultracentrifugal procedure for LDL-C, which was used as a reference. Participants who were pregnant, who had not fasted, or whose plasma contained chylomicrons or floating 0-lipoproteins were excluded. We concluded that a better estimator for LDL-C was provided by the equation LDL-C-TC—(HDL-C+0.16XTG), since it produced an error (relative to the reference method) of lesser magnitude than the previous formula. The expression 0.16XTG (0.37XTG when measurements are reported in millimoles per liter) also produced a more accurate estimate of very low-density lipoprotein cholesterol relative to values obtained by the standard Lipid Research Clinics procedure for this component. The proposed formula is more precise for plasmas or sera with a TG concentration within the normal range.

(JAMA 1986;256:2372-2377)

REFERENCES

Friedewald WT, Levy RI, Fredrickson DS:  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge . Clin Chem 1972;; 18:499-502.
Havel RJ, Eder HA, Bragdon RH:  The distribution and chemical composition of ultracentrifugally separated lipoproteins in human serum . J Clin Invest 1955;;34:1345-1353.
 Lipid Research Clinics Program: Lipid and Lipoprotein Analysis , vol 1, in Manual of Laboratory Operations , Dept of Health, Education, and Welfare publication (NIH) 75-628. Bethesda, Md, National Institutes of Health, 1974;.
The Lipid Research Clinics Program Epidemiology Committee:  Plasma lipid distributions in selected North American populations: The Lipid Research Clinics Program Prevalence Study . Circulation 1979;;60:427-439.
Heiss G, Tamir I, Davis CE, et al:  Lipoproteincholesterol distributions in selected North American populations: The Lipid Research Clinics Program Prevalence Study . Circulation 1980;;61:302-315.
Phillips NR, Havel RJ, Kane JP:  Levels and interrelationships of serum and lipoprotein cholesterol and triglycerides: Association with adiposity and the consumption of ethanol, tobacco, and beverages containing caffeine . Arteriosclerosis 1981;;1:13-24.
Wilson PD, Abbott RD, Garrison RJ, et al:  Estimation of very-low-density lipoprotein cholesterol from data on triglyceride concentration in plasma . Clin Chem 1981;;27:2008-2010.
Srinivasan S, Foster TA, Berenson GS:  Comparability of results by simplified methods for measuring serum lipoprotein cholesterol in a pediatric population . Clin Chem 1980;;26:1548-1553.
Wood PD, Haskel WL, Stern MP, et al:  Plasma lipoprotein distributions in male and female runners . Ann NY Acad Sci 1977;;301:748-752.

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Friedewald WT, Levy RI, Fredrickson DS:  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge . Clin Chem 1972;; 18:499-502.
Havel RJ, Eder HA, Bragdon RH:  The distribution and chemical composition of ultracentrifugally separated lipoproteins in human serum . J Clin Invest 1955;;34:1345-1353.
 Lipid Research Clinics Program: Lipid and Lipoprotein Analysis , vol 1, in Manual of Laboratory Operations , Dept of Health, Education, and Welfare publication (NIH) 75-628. Bethesda, Md, National Institutes of Health, 1974;.
The Lipid Research Clinics Program Epidemiology Committee:  Plasma lipid distributions in selected North American populations: The Lipid Research Clinics Program Prevalence Study . Circulation 1979;;60:427-439.
Heiss G, Tamir I, Davis CE, et al:  Lipoproteincholesterol distributions in selected North American populations: The Lipid Research Clinics Program Prevalence Study . Circulation 1980;;61:302-315.
Phillips NR, Havel RJ, Kane JP:  Levels and interrelationships of serum and lipoprotein cholesterol and triglycerides: Association with adiposity and the consumption of ethanol, tobacco, and beverages containing caffeine . Arteriosclerosis 1981;;1:13-24.
Wilson PD, Abbott RD, Garrison RJ, et al:  Estimation of very-low-density lipoprotein cholesterol from data on triglyceride concentration in plasma . Clin Chem 1981;;27:2008-2010.
Srinivasan S, Foster TA, Berenson GS:  Comparability of results by simplified methods for measuring serum lipoprotein cholesterol in a pediatric population . Clin Chem 1980;;26:1548-1553.
Wood PD, Haskel WL, Stern MP, et al:  Plasma lipoprotein distributions in male and female runners . Ann NY Acad Sci 1977;;301:748-752.
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