Comparison of the effectiveness of Martin’s equation, Friedewald’s equation, and a Novel equation in low-density lipoprotein cholesterol estimation

Abstract

Low-density-lipoprotein cholesterol (LDL-C) is the main target in atherosclerotic cardiovascular disease (ASCVD). We aimed to validate and compare a new LDL-C estimation equation with other well-known equations. 177,111 samples were analysed from two contemporary population-based cohorts comprising asymptomatic Korean adults who underwent medical examinations. Performances of the Friedewald (FLDL), Martin (MLDL), and Sampson (SLDL) equations in estimating direct LDL-C by homogenous assay were assessed by measures of concordance (R2, RMSE, and mean absolute difference). Analyses were performed according to various triglyceride (TG) and/or LDL-C strata. Secondary analyses were conducted within dyslipidaemia populations of each database. MLDL was superior or at least similar to other equations regardless of TG/LDL-C, in both the general and dyslipidaemia populations (RMSE = 11.45/9.20 mg/dL; R2 = 0.88/0.91; vs FLDL: RMSE = 13.66/10.42 mg/dL; R2 = 0.82/0.89; vs SLDL: RMSE = 12.36/9.39 mg/dL; R2 = 0.85/0.91, per Gangnam Severance Hospital Check-up/Korea Initiatives on Coronary Artery Calcification data). MLDL had a slight advantage over SLDL with the lowest MADs across the full spectrum of TG levels, whether divided into severe hyper/non-hyper to moderate hypertriglyceridaemia samples or stratified by 100-mg/dL TG intervals, even up to TG values of 500–600 mg/dL. MLDL may be a readily adoptable and cost-effective alternative to direct LDL-C measurement, irrespective of dyslipidaemia status. In populations with relatively high prevalence of mild-to-moderate hypertriglyceridaemia, Martin’s equation may be optimal for LDL-C and ASCVD risk estimation.

Comparison of Estimated LDL Cholesterol Equations with Direct Measurement in Patients with Angiographically Confirmed Coronary Artery Disease

“…In 2013, the Martin-Hopkins equation replaces the Friedewald equation’s static triglyceride denominator of 5 with a unique factor dependent on TG and non-HDL-C levels and had better accuracy [ 16 , 17 ]. Multiple national and international datasets have been utilized to validate the approach of Martin [ 18 , 19 , 20 , 21 ], including those who received PCSK9i [ 22 , 23 ]. The 2018 AHA/ACC blood cholesterol guideline [ 2 ], 2021 scientific statement from the National Lipid Association [ 6 ], and 2018 joint consensus panel of the European Atherosclerosis Society [ 24 ] all recommended the Martin/Hopkins equation.…”

Directly Measured vs. Calculated Low-Density Lipoprotein Cholesterol Does Not Identify Additional Individuals With Coronary Artery Disease and Diabetes at Higher Risk of Adverse Events: Insight From a Large Percutaneous Coronary Intervention Cohort in Asia

“…In 2013, the Martin-Hopkins equation was created to calculate LDL-C more correctly and categorize people on lipid-lowering medications who had low LDL-C. External validation of Martin’s method has been conducted in multiple national and international datasets ( 8 , 26 – 28 ), including those who received PCSK9i [Evolocumab ( 29 ) and Alirocumab ( 30 )]. Li et al discovered that the Sampson equation is more accurate for determining LDL-C in Chinese patients with acute coronary syndrome than the Friedewald equation ( 31 ).…”

“…In 2013, the Martin-Hopkins equation was created to calculate LDL-C more correctly and categorize people on lipid-lowering medications who had low LDL-C. External validation of Martin's method has been conducted in multiple national and international datasets (8,(26)(27)(28), including those who received PCSK9i [Evolocumab (29) and Alirocumab (30)]. Li (14).…”

Cordova Formula for Low-Density Lipoprotein- Cholesterol Estimation: Not Only the Simplest of All But Also Superior to Other Formulae at a Higher Range of Triglyceride

“…Limited studies have attempted to compare the newly derived formulae of Martin’s and Sampson’s with Cordova’s at higher levels of TG. Vargas-Vázquez et al 8 and Song et al 9 have explored Sampson’s, Martin’s, and Friedewald’s equations in patients with higher TG, but Cordova’s formula was not included in the analysis. Interestingly, Piani et al 10 have compared Martin’s and Sampson’s with Cordova’s formula at higher levels of TG in the Italian population.…”