Key result
Martin/Hopkins equations achieve ~70% concordance with measured LDL-C, outperforming Friedewald and Sampson in elevated triglycerides.
Why the study?
Novel equations have recently been developed to estimate LDL-C in patients with hypertriglyceridemia, warranting validation against a direct homogeneous assay.
Do the Martin/Hopkins and Sampson equations accurately estimate LDL-C compared to direct measurement in patients with hypertriglyceridemia?
Observational (n=52,589)
No
Do the Martin/Hopkins and Sampson equations accurately estimate LDL-C compared to direct measurement in patients with hypertriglyceridemia?
The Martin/Hopkins and extended Martin/Hopkins equations provide the most accurate estimation of LDL-C in patients with hypertriglyceridemia (TG 150-799 mg/dL) when compared to direct Roche assays, avoiding the underestimation seen with Friedewald and Sampson equations.
Martin/Hopkins equations may improve LDL-C estimation accuracy in hypertriglyceridemia; leaves open validation against clinical outcomes.
Background: Recently, novel methods have been developed for the estimation of low-density lipoprotein-cholesterol (LDL-C) in patients with hypertriglyceridemia. Herein, the equations were validated by comparing them to a direct homogeneous assay provided by Roche Diagnostics (Cobas 8000).Methods: LDL-C levels were directly measured using the Roche Cobas assay (DLDL) and estimated using the Friedewald (FLDL), Martin/Hopkins (MLDL), extended Martin/Hopkins (EMLDL), and Sampson (SLDL) equations for 52,589 patients with triglyceride (TG) levels <800 mg/dL.The performance of the four equations was compared using Bland-Altman plots and the mean absolute difference (MAD).The Cochran's Q test was used to compare the performance of various equations between the DLDL and TG groups.Results: The MLDL and EMLDL results were more accurate than the results of other LDL-C equations for TG levels ranging from 400 to 799 mg/ dL (MLDL: MAD=12.63;EMLDL: MAD=13.05;FLDL: MAD=41.46; and SLDL: MAD=20.61;P < 0.001).For TG levels 150 mg/dL, the MLDL and EMLDL results showed superior concordance with the DLDL result (MLDL, 69.9%; EMLDL, 69.8%; SLDL, 58.1%; and FLDL, 38.3%; P < 0.001), indicating that the Martin/Hopkins or extended Martin/Hopkins methods were the most optimal estimation methods for hypertriglyceridemia. Conclusions: The MLDL or EMLDL results were optimal for the accurate estimation of LDL-C levels in clinical laboratories using Roche analyzers for patients with hypertriglyceridemia (TG levels of 150-799 mg/dL).Using the FLDL or SLDL results frequently led to undertreatment due to their tendency for underestimation.
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In et al. (2024) conducted an observational in Hypertriglyceridemia (n=52,589). Martin/Hopkins and extended Martin/Hopkins equations vs. Friedewald and Sampson equations was evaluated on Concordance with directly measured LDL-C for triglyceride levels 150-799 mg/dL (p=<0.001). The Martin/Hopkins and extended Martin/Hopkins equations demonstrated superior concordance (69.9% and 69.8%) with directly measured LDL-C compared to the Friedewald (38.3%) and Sampson (58.1%) equations in patients with triglyceride levels of 150-799 mg/dL.
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