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Year : 2014  |  Volume : 18  |  Issue : 4  |  Page : 502-504

LDL-cholesterol: Friedewald calculated versus direct measurement-study from a large Indian laboratory database

1 Consultant, Endocrinology Diabetes and Bariatric Medicine, Narayana Health City, Bangalore, Karnataka, India
2 Endocrine and Speciality Clinic, Chennai, India
3 Assistant Professor Endocrinology, Chettinad Medical College, Chennai, India
4 Consultant Endocrinologist, Arka Center for Hormonal Health, Chennai, India
5 Department of Clinical Endocrinology, Alpha Hospital and Research Centre, Anuppanady, Madurai, Tamil Nadu, India

Correspondence Address:
Shriraam Mahadevan
Endocrine and Speciality Clinic, 4th Cross Street, R K Nagar, Mandaveli, Chennai 600 028, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2230-8210.137496

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Background: Validity of Friedewald formula (FF) in patients with serum triglycerides (TGs) <400 mg/dl is unclear. Materials and Methods: We compared low-density lipoprotein (LDL)-cholesterol calculated by FF to directly measured LDL in a laboratory database of 14,620 lipid profile samples from south India. Results: LDL by FF correlated with directly measured LDL with correlation coefficient of 0.89 with the best correlation seen in TG levels 100-150. Higher level of TG (>200) underestimates the LDL calculated by FF particularly at LDL values <70 mg/dl. On the other hand, LDL is overestimated by FF in more than 70% of cases at LDL levels >130 mg/dl. Conclusion: We suggest repeating the LDL by direct assay techniques particularly in patients with TG >200 and when LDL <70 or >130. This helps in correctly stratifying the coronary artery diseases' (CADs') risk and goals of treatment.

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