Comparison of Performance of Various Calculated Low-Density Lipoprotein (LDL) Methods in the Indian Population: A Hospital-Based Study

TL;DR

This study compares different methods for calculating LDL cholesterol in an Indian population and finds that the Martin-Hopkins formula is more accurate than other methods.

Contribution

The study evaluates LDL-C calculation methods in the Indian population and identifies the Martin-Hopkins formula as the most accurate.

Findings

The Martin-Hopkins formula showed better agreement with direct LDL-C measurements compared to Friedwald and Sampson's formulas.

The Martin-Hopkins formula performed well in both groups with TG levels below and above 400 mg/dL.

Bland-Altman plots and concordance correlation coefficients confirmed the superior accuracy of the Martin-Hopkins formula.

Abstract

Introduction: In recent times, there has been a surge in proposed alternative approaches to computing low-density lipoprotein cholesterol (LDL-C), with a focus on enhancing precision, particularly within diverse demographic and clinical groups. Our aim is to assess the agreement, precision, and practicality of these methods compared to direct LDL-C measurements, with the goal of identifying the most effective approach for estimating LDL-C in the Indian context.

Methods: It is a retrospective analytical study. Lipid profile data were gathered from the laboratory and organized in Microsoft Excel for analysis. LDL-C was computed using three different methods: the Friedwald formula, the Martin-Hopkins formula, and Sampson's formula. These calculations were then compared with the direct method of LDL-C estimation in two distinct groups: when triglyceride (TG) levels were less than 400 mg/dL and when TG levels exceeded 400 mg/dL. Bland-Altman plots were generated, and concordance correlation coefficients (CCCs) were computed to determine the most suitable calculated method.

Results: Data from 1,776 participants were analysed and divided into two groups. In both Group 1 (TG < 400 mg/dL) and Group 2 (TG > 400 mg/dL) considering bias, limits of agreements, and correlation coefficient, as seen on the Bland-Altman and CCC, Martin-Hopkins equation was found to be performing better than Friedwald and Sampson’s equation.

Conclusion: In this study, the Martin-Hopkins formula appears to be the most appropriate choice for precise LDL-C level measurements and indicated improved accuracy and consistency in LDL-C measurements, especially in individuals with elevated TG levels. This underscores its importance in ensuring precise assessment and suitable clinical management.

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