Developing a Modified Low-Density Lipoprotein (M-LDL-C) Friedewald's Equation as a Substitute for Direct LDL-C Measure in a Ghanaian Population: A Comparative Study.

Authors:
Mr. Enoch Odame Anto, BSc, MPhil, PhD candidate
Mr. Enoch Odame Anto, BSc, MPhil, PhD candidate
Edith Cowan University
PhD candidate
Perth, WA | Australia
Mr Prince Adoba, Bachelor's degree
Mr Prince Adoba, Bachelor's degree
Kwame Nkrumah University of Science and Technology
Mr
Biomedical Research
Cape Coast, Central | Ghana
Patrick Adu
Patrick Adu
University of Cape Coast
Dr
haemoglobinopathy
Cape Coast, Central Region | Ghana

J Lipids 2018 31;2018:7078409. Epub 2018 Dec 31.

Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Ghana.

Despite the availability of several homogenous LDL-C assays, calculated Friedewald's LDL-C equation remains the widely used formula in clinical practice. Several novel formulas developed in different populations have been reported to outperform the Friedewald formula. This study validated the existing LDL-C formulas and derived a modified LDL-C formula specific to a Ghanaian population. In this comparative study, we recruited 1518 participants, derived a new modified Friedewald's LDL-C (M-LDL-C) equation, evaluated LDL-C by Friedewald's formula (F-LDL-C), Martin's formula (N-LDL-C), Anandaraja's formula (A-LDL-C), and compared them to direct measurement of LDL-C (D-LDL-C). The mean D-LDL-C (2.47±0.71 mmol/L) was significantly lower compared to F-LDL-C (2.76±1.05 mmol/L), N-LDL-C (2.74±1.04 mmol/L), A-LDL-C (2.99±1.02 mmol/L), and M-LDL-C (2.97±1.08 mmol/L) p < 0.001. There was a significantly positive correlation between D-LDL-C and A-LDL-C (r=0.658, p<0.0001), N-LDL-C (r=0.693, p<0.0001), and M-LDL-C (r=0.693, p<0.0001). M-LDL-c yielded a better diagnostic performance [(area under the curve (AUC)=0.81; sensitivity (SE) (60%) and specificity (SP) (88%)] followed by N-LDL-C [(AUC=0.81; SE (63%) and SP (85%)], F-LDL-C [(AUC=0.80; SE (63%) and SP (84%)], and A-LDL-C (AUC=0.77; SE (68%) and SP (78%)] using D-LDL-C as gold standard. Bland-Altman plots showed a definite agreement between means and differences of D-LDL-C and the calculated formulas with 95% of values lying within ±0.50 SD limits. The modified LDL-C (M-LDL-C) formula derived by this study yielded a better diagnostic accuracy compared to A-LDL-C and F-LDL-C equations and thus could serve as a substitute for D-LDL-C and F-LDL-C equations in the Ghanaian population.

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Source
http://dx.doi.org/10.1155/2018/7078409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6332996PMC
December 2018
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Clinical Chemistry 1995

Journal of Clinical and Diagnostic Research 2015

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