Avaliação da dosagem direta do colesterol-LDL em amostras de sangue de 10.664 pacientes em comparação com o uso da fórmula de Friedewald

作者：Caio Maurício Mendes de Córdova, Carlos Rudi Schneider, Iara Deise Juttel, Maurício Mendes de Cordova · 发表于：Arquivos Brasileiros de Cardiologia · 年份：2004 · DOI：10.1590/s0066-782x2004001800006 · 被引用次数：75 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Medical research and treatments、Antioxidant Activity and Oxidative Stress

OBJECTIVE: To compare direct measurement of LDL-cholesterol (LDL-C) determined by a homogeneous method with LDL-cholesterol estimation determined by the Friedewald formula in a large heterogeneous population. METHODS: The measurements of total cholesterol (TC) and triglycerides (TG) were performed using traditional enzymatic methods. The measurements of HDL-C and LDL-C were performed using direct methods with no precipitation, and the estimation of the LDL-C fraction was calculated using the Friedewald formula. RESULTS: On linear regression analysis, the 2 methods had extremely significant correlation coefficients (P < 0.001). However, the Friedewald formula had a positive bias in regard to the direct method, more pronounced with TC levels > 201 mg/dL. This positive bias also occurred in regard to TG levels < or =150 mg/dL. No bias was observed between the methods for TG levels ranging from 151 to 200 mg/dL and from 201 to 300 mg/dL. On the other hand, for TG levels ranging from 301 to 400 mg/dL, this bias of the Friedewald formula became negative. CONCLUSION: The Friedewald formula did not have a homogeneous performance for estimating LDL-C levels in samples with different TG levels as compared with that of the direct method, what could launch doubts on patients classification on the risk of developing coronary artery disease.