Validity of the Conventional Indirect Methods Including Friedewald Method for Determining Serum Low-Density Lipoprotein Cholesterol Level: Comparison with the Direct Homogeneous Enzymatic Analysis

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• Validity of the Conventional Indirect Methods Including Friedewald Method for Determining Serum Low-Density Lipoprotein Cholesterol Level: Comparison with the Direct Homogeneous Enzymatic Analysis: Noriyuki NAKANISHI, et al. Department of Social and Environmental Medicine, Course of Social Medicine, Osaka University, Graduate School of Medicine F2- Low-density lipoprotein cholesterol (LDLC) concentrations are most commonly estimated by the Friedewald formula [LDLC=total cholesterol (TC) - high-density lipoprotein cholesterol - triglycerides (TG) / 5]. To assess the validity of the conventional indirect methods including Friedewald method for determining serum LDLC level, we analyzed 1953 serum samples from Japanese male office workers and compared the measured (the direct N-geneous assay) serum LDLC concentrations with calculated values, by using several terms for TG (i.e., TG / 4, TG / 4.5, TG / 5, TG / 5.5, TG / 6, TG / 7, and TG / 8) in the Friedewald formula. Linear regression analyses showed the highest correlation for the estimated LDLC by the original Friedewald formula, with the term TG / 5, with the measured LDLC (r=0.958). The mean LDLC estimated by means of the original Friedewald formula was 1.4 mg / dl higher than the mean measured LDLC (p<0.001), but the difference between the mean estimated LDLC and the mean measured LDLC was the smallest for estimation by means of the original Friedewald formula. As for the accuracy of calculation methods, TG / 5 agreed best with the direct assay for TG concentrations__<99 mg / dl and TG / 4.5 was best for TG concentrations of 100-249 mg / dl. For TG concentrations __>250 mg / dl, TG / 5 most closely matched the measured LDLC and gave the smallest mean percent errors, but with increasingly large estimation errors as TG increased. As for the accuracy of calculation methods according to lipidemic type, TG / 5 was the best estimating term for normolipidemics (TC __<219 mg / dl and TG __<149 mg / dl) and hypertriglyceridemics (TC__<219 mg / dl and TG __>150 mg / dl), but the percentages of samples correctly estimated decreased with increasing TG concentrations. These results suggest that the original Friedewald formula, with the term TG / 5, is reasonably well classified at TG concentrations __<99 mg / dl or in normolipidemics, but the potential for significant estimation errors steadily increases with increasing TG concentrations. We conclude that direct LDLC assay such as the N-geneous method is a useful tool in the diagnosis and management of hypercholesterolemics, especially for those with increased TG.

• 社団法人日本産業衛生学会の論文

著者

• Matsui Yoshio

  Department Of Cardiology Jichi Medical University School Of Medicine

• Suzuki K

  School Of Science And Engineering Waseda University:kagami Memorial Laboratory For Materials Science

• Suzuki Kenji

  Kdd R & D Laboratories

• Suzuki Kenji

  Japan Labor And Welfare Association

• Suzuki Kenji

  Institute For Materials Research Laboratory Tohoku University

• TATARA Kozo

  Department of Public Health, Osaka University Medical School

• MATSUO Yoshio

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Matsuo Yoshio

  Department Of Clinical Radiology Graduate School Of Medical Sciences Kyushu University

• Matsuo Y

  Department Of Social And Environmental Medicine Course Of Social Medicine Osaka University Graduate

• Suzuki K

  Ntt Transmission Systems Laboratories Lightwave Communications Laboratory

• Suzuki K

  Assoc. Super‐advanced Electronics Technol. Kanagawa Jpn

• NAKANISHI Noriyuki

  Department of Public Health Osaka University Medical School

• YONEDA Hideo

  Department of Public Health Osaka University Medical School

• Yoneda Hideo

  Department Of Social And Environmental Medicine Course Of Social Medicine Osaka University Graduate

• Nakamura K

  Center For Experimental Medicine Institute Of Medical Science University Of Tokyo

• Suzuki K

  Department Of Information And Communication Technology Tokai University

• Nakamura Koji

  Division Of Social And Environmental Medicine Department Of Community Preventive Medicine Niigata Un

• Tatara Kozo

  Department Of Public Health And Neurosurgery Osaka University Medical School

• Suzuki K

  東京大学大学院農学生命科学研究科獣医病理学研究室

• Nakajima Kazue

  Department Of Public Health Osaka University Medical School

• Nakanishi Noriyuki

  大阪大学 医学系研究科社会環境医学

• Nishi Nobuo

  Department Of Social And Environmental Medicine Course Of Social Medicine Osaka University Graduate

• NAKAMURA Koji

  Medical Office, Osaka Main Office, Takenaka Corporation

• Suzuki Kenji

  Japan International Research Center For Agricultural Sciences

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