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BackgroundDirectly measured low density lipoprotein cholesterol (DLDLC) has been reported to be more accurate than calculated low density lipoprotein cholesterol (CLDLC) using the Friedewald equation. However, some limitations of DLDLC have been reported. In this study, we evaluated differences between CLDLC and DLDLC measured using HiSens reagents.MethodsData were collected from 582 persons undergoing routine physical examinations at a general hospital. LDLC measurements were made directly or estimated using the Friedewald formula, and were classified according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines. The relationship between these differences and other clinically relevant factors, such as triglyceride (TG) levels, were examined using multiple logistic regression analysis.ResultsThe DLDLC and CLDLC were strongly correlated according to simple linear regression analysis (r=0.917, P<0.001) but the mean difference between measurements was -11.0±15.3 (-62 to 90.5) mg/dL (P<0.001). For more than 10 mg/dL of their absolute differences, the DLDLC was typically lower than the CLDLC. The highest discrepancies in LDLC measurements occurred when LDLC was more than 160 mg/dL and less than 190 mg/dL. Differences in LDLC measurements were prone to striking negative and positive biases dependent on CLDLC and TG concentrations, respectively (all r>0.5).ConclusionUnlike other studies, DLDLC was significantly lower than CLDLC and the large differences in LDLC concentrations were not dependent on TG concentration. Our work suggests that verification of DLDLC accuracy is needed and differences in LDLC measurements should be accounted for in making clinical decisions.

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Background: Some previous studies have claimed that electronic cigarette (e-cigarette) use is helpful in quitting smoking. However, this role of e-cigarettes remains uncertain because several current smokers use e-cigarettes as an alternative to tobacco smoking. The present study aimed to compare the quitting behaviors of dual users and cigarette-only smokers. Methods: Data of 5,179 current smokers from the sixth and seventh Korea National Health and Nutrition Examination Surveys (2013-2017) were analyzed. Current smokers were divided into dual users and cigarette-only smokers based on e-cigarette use in the past month. Factors influencing e-cigarette use were investigated. Differences in the quitting behaviors between both groups were assessed using multivariate logistic regression analysis with STATA 11.0. Results: Young age (＜40 years) and smoking amount (＞20 cigarettes/day) were associated with e-cigarette use. Nicotine replacement therapy (NRT) use in the past 5 days was associated with e-cigarette use [odds ratio (OR), 5.328; 95% confidence interval (CI), 2.377-11.941]. Dual users demonstrated higher quit attempts in the past year (OR, 1.600; 95% CI, 1.113-2.301). There was no difference between dual users and cigarette-only smokers in choosing an evidence-based quit method such as using a quit line or visiting a smoking cessation clinic. However, dual use was associated with use of NRT over the counter NRT use. Conclusion: There are no differences in employing an evidence-based smoking cessation method between dual users and cigarette-only smokers, despite the higher quit attempts in dual users. Further evaluation of the effect of NRT use as a quitting method on dual users is warranted. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.