Update on low-density lipoprotein cholesterol quantification. Issue 4 (August 2019)

• Record Type: Journal Article
• Authors: Chung, Soie
• Is Part Of: Current opinion in lipidology. Volume 30:Issue 4(2019)
• Publication Date: 2019-08
• Subjects: β-Quantification -- Friedewald equation -- homogeneous assay -- low-density lipoprotein cholesterol -- Martin's method; Lipids -- Periodicals; 572.574
• DOI: 10.1097/MOL.0000000000000611
• Languages: English
• ISSNs: 1473-6535

Abstract

Abstract : Purpose of review: β-Quantification is considered the reference measurement procedure for low-density lipoprotein cholesterol (LDL-C). However, this technique is time-consuming and thus is inappropriate for routine clinical practice. Therefore, the Friedewald equation or homogeneous assays have been widely utilized. As several pitfalls exist with these two methods, a novel method for estimating LDL-C was developed by Martin et al. Recent findings: Martin's method uses a strata-specific median for the triglycerides/very low-density lipoprotein cholesterol (VLDL-C) ratio on the basis of triglycerides and non-HDL-C concentrations. Recent studies show that Martin's method better correlates with β-quantification or homogeneous assays compared with the Friedewald equation, especially with values of triglycerides at least 150 mg/dl and/or LDL-CD less than 70 mg/dl. Such findings have also been demonstrated in other ethnic groups (Japanese and Korean) and disease populations, including diabetes and cardiovascular disease, in which the triglycerides/VLDL-C ratio can be affected. Summary: For the current therapeutic goal of LDL-C values below 70 mg/dl in high-risk patients, accurate assessment of LDL-C levels at very low levels is required. Martin's method could overcome pitfalls such as underestimation of the Friedewald equation at this level. Further evaluation of the triglycerides/VLDL-C ratio in participants with diverse ethnic backgrounds or clinical conditions would expand the implementation of this novel method.