Comparison of ten formulae for calculating low-density lipoprotein cholesterol with direct low-density lipoprotein cholesterol measurement

ABSTRACT Background: Accurate lipid profile assessment, mainly low-density lipoprotein cholesterol (LDL-C) measurement, is crucial for diagnosing and managing cardiovascular disease (CVD). The widely used Friedewald formula for LDL-C calculation has limitations, prompting the exploration of alternative equations. Aims: This study aims to compare ten LDL-C calculation formulas with direct measurement among study participants attending a tertiary care centre. Materials and Methods: Conducted from September 2021 to July 2022 at a tertiary healthcare centre in India, the study involved 114 participants aged 18 years or older. The exclusion criteria were high-serum triglyceride (TG) levels, renal failure, diabetes, liver diseases or unwillingness to participate. Blood samples were analysed for total cholesterol, TG, high-density lipoprotein cholesterol and LDL-C. The very-low-density lipoprotein cholesterol level was calculated. The LDL-C formulas evaluated were Friedewald, Anandaraja, De Cordova, Vujovic, Ahmadi, Puavillai, Chen, Hattori, Martin-Hopkin and Sampson. Results: Vujovic's formula showed a negligible mean difference and strong correlation (r = 0.916, P < 0.001) with direct LDL-C estimation across TG concentrations. Sampson's formula performed best for TG