Key result
Serum Lp(a) concentrations >600 mg/L vs <=300 mg/L led to a 21.4% vs 4.1% mean overestimation of LDL-C by the Friedewald formula (P<0.001 for correlation).
Cross-Sectional (n=23)
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The calculation of serum low-density lipoprotein cholesterol (LDL-C) by the Friedewald formula does not account for the cholesterol associated with lipoprotein(a) [Lp(a)]. To quantify the contribution of Lp(a) cholesterol to total serum cholesterol, we measured concentrations of serum Lp(a) by an ELISA and concentrations of other serum lipids and lipoproteins by standard assays in 23 normolipemic women, ages 50-60 years. In measuring serum high-density lipoprotein we found that polyethylene glycol 6000 precipitated > 99.8% of all Lp(a). When serum Lp(a) concentrations were < or = 300 mg/L, 301-600 mg/L, and > 600 mg/L, the uncorrected serum LDL-C was overestimated, respectively, by a mean of 4.1% (n = 7), 8.5% (n = 8), and 21.4% (n = 8). Serum Lp(a) concentrations were positively correlated with percentage overestimation (P < 0.001), but were not correlated with either corrected or uncorrected serum LDL-C. We conclude that the Friedewald formula should be modified to take into account the contribution of Lp(a) cholesterol to total serum cholesterol.
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Li et al. (1994) conducted a cross-sectional in Normolipemia (n=23). Serum lipoprotein(a) > 600 mg/L vs. Serum lipoprotein(a) <= 300 mg/L was evaluated on Percentage overestimation of uncorrected serum LDL-C by the Friedewald formula (p=<0.001). Serum Lp(a) concentrations >600 mg/L vs <=300 mg/L led to a 21.4% vs 4.1% mean overestimation of LDL-C by the Friedewald formula (P<0.001 for correlation).
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