Korean J Fam Med 2017; 38(5): 263-269  https://doi.org/10.4082/kjfm.2017.38.5.263
Martin’s Equation as the Most Suitable Method for Estimation of Low-Density Lipoprotein Cholesterol Levels in Korean Adults
Mijeong Kang, Jongwoo Kim*, Seon Yeong Lee, Kyunam Kim, Junehyung Yoon, Hongseok Ki
Department of Family Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
Jongwoo Kim Tel: +82-2-950-1150, Fax: +82-2-952-4093, E-mail: s2700@paik.ac.kr
Received: October 20, 2016; Revised: October 24, 2016; Accepted: October 24, 2016; Published online: September 20, 2017.
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Abstract
Background: Friedewald equation is the most widely used method for estimating low-density lipoprotein cholesterol (LDL-C) level. However, due to potential over- or underestimation, many studies have used a modified equation. This study aimed to compare estimates by 4 different equations to directly measured LDL-C concentrations in order to propose the most appropriate method for LDL-C estimation in the Korean population.
Methods: We studied data of 4,350 subjects that included total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and LDL-C concentrations that had been measured at one university hospital in Seoul. We investigated 4 equations: LDL-C by Friedewald’s original equation (LDL-CF) and its 3 modifications. Pearson correlation analysis was performed to compare these estimates to the direct measurement.
Results: Pearson correlation analysis revealed a good correlation among all 4 estimated LDL-C values and the directly measured LDL-C value. The Pearson coefficients were 0.951 for LDL-CF, 0.917 for LDL-C by Hatta equation (LDL-CH), 0.968 for LDL-C by Puavilai equation (LDL-CP), and 0.983 for LDL-C by Martin equation (LDL-CM). Martin equation (LDL-CM) resulted in the best approximation (mean difference from the direct measurement, 5.5 mg/dL; mean percentage difference from the direct measurement, 5.1%) and the best agreement with the direct measurement (86.1%). LDL-CP resulted in the second-best approximation (mean difference, 7.0 mg/dL; mean percentage difference, 6.2%; concordance, 82.5%). LDL-CM was found to be less influenced by TG and HDL-C levels than by LDL-CF.
Conclusion: Estimates by Martin equation had the best agreement with direct LDL-C concentrations and both Martin and Puavilai equations were superior to Friedewald equation for estimating LDL-C concentrations in Korean adults.
Keywords: Dyslipidemias; Low-Density Lipoprotein Cholesterol; Friedewald Equation; Martin Equation


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