• 대한임상검사과학회지
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• 제44권3호
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• pp.103-111
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• 2012

Low-Density Lipoprotein cholesterol (LDLC) is the most important marker for the treatment of hyperlipidemia in NCEP-ATP III(National Cholesterol Education Program-Adult Treatment Panel III) guideline. Therefore, LDL cholesterol is pathologically meaningful, accurate measurement should be a top priority. Currently, LDLC is directly measured in most cases, but, the estimate is still used in mass health examination or screening test. This study is about the comparison of LDL-Cholesterol direct measurement with the estimate using various formula (Friedewald: [LDL-F=TC-HDL-TG/5], Nakajima: [LDL-N=TC-HDL-TG/4], Hattori: [LDL-H =0.94TC-0.94HDL-0.19TG], Puavilai: [LDL-P=TC-HDL-TG/6], Carvalho: [LDL-C=3(TC-HDL)/4]) for calculating more accurate value. We analyzed total cholesterol (TC), try-glyceride (TG), high-density lipoprotein cholesterol (HDLC), and LDLC levels of 210 subjects between June and November in 2011. Until now, the Friedewald formula is the most commonly used estimate for the LDLC. When Friedewald formula was applied, the correlation coefficient (r) was 0.940, showing high correlation. But, the result of the direct method was significantly different, compared with those of the Friedewald formula in triglyceride levels ${\geq}400mg/dL$(p<0.05). There was the highest correlation when we used LDL-P formula(r=0.947) in triglyceride levels <400 mg/dl. Also there was the lowest mean difference regardless of triglyceride level. Therefore, the study showed that TG/6 is more precise means of calculation than TG/5. On the other hand, the calculation of LDL-Cholesterol was underestimated, compared with direct measurement. It is necessary to have more data and modified Friedewald formula should be used for the accurate calculation.

• 한국산학기술학회논문지
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• 제16권8호
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• pp.5492-5500
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• 2015

LDL-콜레스테롤(LDL-C)은 심뇌혈관질환의 주된 교정 가능한 위험인자로서, 정확한 측정값을 임상에 적용하는 것이 중요하다. 하지만 LDL-C의 측정은 실제 측정이 아닌 Friedewald 공식에 의한 계산방법이 널리 이용되고 있다. 본 연구의 목적은 LDL-C의 Friedewald-추정값과 실측값을 비교하고, 두 방법의 LDL-C 위험수준 분류 일치도를 평가하는 것이다. 표본은 국민건강영양조사 2개년(2009년과 2010년)의 공개된 자료에서 추출되었고, 혈액 검사에서 총 콜레스테롤, HDL-콜레스테롤, 직접 측정한 LDL-C, 그리고 중성지방 중 어느 한 결측치도 없는 4,319명을 연구대상으로 하였다. 중성지방 400 mg/dL 미만일 때, Friedewald-추정값과 실측값은 높은 상관관계를 보였고 (r = 0.958, p < 0.001), 위험수준 분류 일치 백분율은 82.7%이었다. 중성지방 수준이 높을수록, 일치 백분율은 낮았다. 중성지방 수준 150 mg/dL 미만, 150-200 mg/dL, 그리고 200-399 mg/dL일 때, 일치 백분율은 각각 85.4%, 78.2%, 그리고 71.4%이었다. Friedewald 공식은 중성지방 농도 150 mg/dL 미만에서는 LDL-C를 과대평가하는 반면, 중성지방 농도 150 mg/dL 이상에서는 과소평가하는 경향이 있었다. 이에 따라 LDL-C 위험수준 분류에 있어 그 범주가 과대평가된 사람은 382명 (9.1%)인 반면, 과소평가된 사람은 348명 (8.3%)이었다. 이러한 결과는 Friedewald-추정값의 LDL-C 과소평가뿐만 아니라, 과대평가도 심각한 문제일 수 있음을 제시한다.

• 대한임상검사과학회지
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• 제45권2호
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• pp.54-59
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• 2013

NonHDL cholesterol values have been suggested as a risk marker for cardiovascular disease. NonHDL cholesterol values were calculated, using a very simple measurement [nonHDL cholesterol=serum total cholesterol-HDL cholesterol]. This formula is very useful as a screening tool for identifying dyslipoproteinemias, risk assessment, and assessing the results of hypolipidemic therapy. The data from the 2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,992 subjects with lipid panels (Cholesterol, HDL, LDLdirect and Triglycerides) results. We studied the relationship between nonHDL cholesterol and LDL cholesterol. As a result, nonHDL cholesterol values were plotted against the LDL direct and calculated values. The linear regression equation for nonHDL cholesterol and direct LDL cholesterol was $nonHDLchol=23.60+1.03{\times}LDLdirect$ (p<0.0001, $r^2=0.80$) in all subjects. The subjects were classified into triglyceride values. When triglycerides are below 400 mg/dL, the linear fit to LDL direct is found to be $[nonHDLchol=17.34+1.07{\times}LDLdirect]$ (p<0.0001, $r^2=0.88$) and to the Friedewald LDL calculation is $[nonHDLchol=23.10+1.02{\times}LDLcalc]$ (p<0.0001, $r^2=0.82$). For triglycerides above 400 mg/dL, the linear fit equation is $[nonHDLchol=87.57+0.92{\times}LDLdirect]$ (p<0.0001, $r^2=0.50$) and to the LDL calculated, it is $[nonHDLchol=142.70+0.50{\times}LDLcalc]$ (p<0.0001, $r^2=0.32$). This study provides examples of the utility of nonHDL cholesterol concentrations in clinical medicine.