Background

The Martin/Hopkins low-density lipoprotein cholesterol equation (LDL-C_N) was previously demonstrated as more accurate than Friedewald LDL-C estimation (LDL-C_F) in a North American database not able to take race into account.

Objectives

We hypothesized that LDL-C_N would be more accurate than LDL-C_F and correlate better with LDL particle number (LDL-P) in a racially diverse Brazilian cohort.

Methods

We performed a cross-sectional analysis of 4897 participants in the Brazilian Longitudinal Study of Adult Health, assessing LDL-C_F and LDL-C_N accuracy via overlap with ultracentrifugation-based measurement among clinical guideline LDL-C categories as well as mg/dL and percent error differences. We analyzed by triglyceride categories and correlated LDL-C estimation with LDL-P.

Results

LDL-C_N demonstrated improved accuracy at 70 to <100 and <70 mg/dL (P < .001), with large errors ≥20 mg/dL about 9 times more frequent in LDL-C_F at LDL-C <70 mg/dL, mainly due to underestimation. Among individuals with LDL-C <70 mg/dL and triglycerides ≥150 mg/dL, 65% vs 100% of ultracentrifugation-based low-density lipoprotein cholesterol calculation fell within appropriate categories of estimated LDL-C_F and LDL-C_N, respectively (P < .001). Similar results were observed when analyzed for age, sex, and race. Participants at LDL-C <70 and 70 to <100 mg/dL with discordantly elevated LDL-C_N vs LDL-C_F had a 58.5% and 41.5% higher LDL-P than those with concordance (P < .0001), respectively.

Conclusions

In a diverse Brazilian cohort, LDL-C_N was more accurate than LDL-C_F at low LDL-C and high triglycerides. LDL-C_N may avoid underestimation of LDL-C and better reflect atherogenic lipid burden in low particle size, high particle count states.

中文翻译：

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改良的低密度脂蛋白胆固醇评估对现代治疗时代指南分类的影响-来自巴西不同种族的横断面研究的结果。

背景

先前在无法考虑种族因素的北美数据库中，已证明马丁/霍普金斯低密度脂蛋白胆固醇方程（LDL-C _N）比弗里德瓦尔德（Friedewald）LDL-C估计（LDL-C _F）更准确。

目标

我们假设，LDL-C _Ñ会比LDL-C更准确_˚F并将其与以不同种族巴西队列LDL粒子数（LDL-P）相关更好。

方法

我们对巴西成人健康纵向研究中的4897名参与者进行了横断面分析，通过在临床指南LDL-C类别和mg / dL之间采用超速离心法进行重叠评估来评估LDL-C _F和LDL-C _N的准确性和百分比误差差异。我们通过甘油三酸酯类别进行分析，并将LDL-C估计与LDL-P相关联。

结果

LDL-C _N在70至<100和<70 mg / dL时显示出更高的准确度（P  <.001），LDL-C <70 mg时LDL-C _F的大误差≥20mg / dL约高9倍/ dL，主要是由于低估了。在LDL-C <70 mg / dL和甘油三酸酯≥150mg / dL的个体中，基于超速离心的低密度脂蛋白胆固醇计算的65％vs 100％属于估计的LDL-C _F和LDL-C _N的适当类别，分别为（P  <.001）。在分析年龄，性别和种族时，观察到相似的结果。LDL-C <70和70至<100 mg / dL的参与者LDL-C _N与LDL-C _F明显升高的LDL-P分别比一致的患者高58.5％和41.5％（P  <.0001）。

结论

在不同的巴西队列中，在低LDL-C和高甘油三酸酯的情况下，LDL-C _N比LDL-C _F更准确。LDL-C _N可以避免低估LDL-C，并在低粒径，高颗粒数状态下更好地反映动脉粥样硬化性脂质负荷。