Diabetes Care, Vol 16, Issue 8 1081-1086, Copyright © 1993 by American Diabetes Association

ARTICLES

Calculated low-density lipoprotein cholesterol should not be used for management of lipoprotein abnormalities in patients with diabetes mellitus

J Rubies-Prat, JL Reverter, M Senti, J Pedro-Botet, I Salinas, A Lucas, X Nogues and A Sanmarti
Department of Medicine, Hospital del Mar, Universidad Autonoma de Barcelona, Spain.

OBJECTIVE--To assess the validity of calculated low-density lipoprotein cholesterol by the Friedewald formula for management of lipoprotein abnormalities in patients with diabetes mellitus. RESEARCH DESIGN AND METHODS--Calculated LDL cholesterol by the Friedewald formula was compared with measured LDL cholesterol after separation by ultracentrifugation in 61 patients with type I diabetes, 50 patients with type II diabetes, and 116 healthy control subjects. RESULTS--Calculated LDL cholesterol coincided with measured LDL cholesterol, with < 10% error, in 54 (49%) patients with diabetes mellitus, and 85 (73%) control subjects. Calculated LDL cholesterol was overestimated, with an error of > or = 10% of measured LDL cholesterol in 39% of patients and 26% of control subjects, and underestimated in 13 and 1%, respectively. Despite a good correlation between calculated and measured LDL cholesterol, the intraclass correlation coefficients demonstrated a poor concordance between calculated and measured LDL cholesterol, both in patients and control subjects. When comparing the mean differences of calculated and measured LDL cholesterol for diabetic subjects versus control subjects, significantly greater differences in type II (but not type I) diabetic subjects were seen. CONCLUSIONS--Calculation of LDL cholesterol by the Friedewald formula may be inaccurate for assessment of cardiovascular risk in patients with type II diabetes and may not be appropriate for management of lipoprotein abnormalities in those diabetic patients.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				E. T. Bairaktari, K. I. Seferiadis, and M. S. Elisaf Evaluation of Methods for the Measurement of Low-Density Lipoprotein Cholesterol Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 2005; 10(1): 45 - 54. [Abstract] [PDF]

				S. H. Hsia Non-HDL Cholesterol: Into the Spotlight Diabetes Care, January 1, 2003; 26(1): 240 - 242. [Full Text] [PDF]

				K.-Z. Liu, R. A. Shaw, A. Man, T. C. Dembinski, and H. H. Mantsch Reagent-free, Simultaneous Determination of Serum Cholesterol in HDL and LDL by Infrared Spectroscopy Clin. Chem., March 1, 2002; 48(3): 499 - 506. [Abstract] [Full Text] [PDF]

				M. Nauck, G. R. Warnick, and N. Rifai Methods for Measurement of LDL-Cholesterol: A Critical Assessment of Direct Measurement by Homogeneous Assays versus Calculation Clin. Chem., February 1, 2002; 48(2): 236 - 254. [Abstract] [Full Text] [PDF]

				A. M. Wagner, J. L. Sanchez-Quesada, A. Perez, M. Rigla, M. Cortes, F. Blanco-Vaca, and J. Ordonez-Llanos Inaccuracy of Calculated LDL-Cholesterol in Type 2 Diabetes: Consequences for Patient Risk Classification and Therapeutic Decisions Clin. Chem., November 1, 2000; 46(11): 1830 - 1832. [Full Text] [PDF]

				M. Senti, J. Pedro-Botet, J. Rubies-Prat, and F. Vidal-Barraquer Secondary Prevention of Coronary Heart Disease in Patients with Extracoronary Atherosclerosis: A Need for Accuracy of Low Density Lipoprotein Determination Angiology, March 1, 1996; 47(3): 241 - 246. [Abstract] [PDF]

				R. J. Havel and E. Rapaport Management of Primary Hyperlipidemia N. Engl. J. Med., June 1, 1995; 332(22): 1491 - 1498. [Full Text] [PDF]