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Open Access Highly Accessed Research article

Comparison of various formulae for estimating low-density lipoprotein cholesterol by a combination of ages and genders in Taiwanese adults

Chung-Huang Tsai1, Hsin-Hung Wu2 and Shao-Jen Weng3*

Author Affiliations

1 Department of Family Medicine, Chung-Kang Branch, Cheng Ching General Hospital, Taichung 40799, Taiwan

2 Department of Business Administration, National Changhua University of Education, Changhua 500, Taiwan

3 Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40704, Taiwan

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BMC Cardiovascular Disorders 2014, 14:113  doi:10.1186/1471-2261-14-113

Published: 2 September 2014

Abstract

Background

The accuracy and precision of the Friedewald formula for estimating low-density lipoprotein cholesterol (LDL-C) is questionable. Although other formulae have been developed, only a few studies compare them. Thus, we compared the efficiencies of various formulae, based on the age and gender of adults, to determine which ones yield more accurate estimations in terms of mean squared error, and which formulae underestimated and overestimated LDL-C performance.

Methods

This study compares various formulae in terms of mean squared error (MSE), as well as underestimation and overestimation of LDL-C concentrations, using subjects of various ages and both genders. Six groups were examined in this study based on age and gender: males 20–44 years old, 45–64, and 65 and above, and females in the same three age ranges.

Results

The results show that the Friedewald formula has relatively low accuracy, and while its performance among older (aged 45 and above) women with triglyceride concentrations ≤ 400 mg/dL is better than that with other groups, it is still more inaccurate than the other formulae. In terms of prediction errors and mean squared errors, Tsai’s formula (TF) and a calibrated TF provide the most accurate results with regard to the LDL-C concentration. Moreover, based on a cross-validation of age and gender, these two formulae provide highly accurate results for the LDL-C concentrations of all the studied groups, except for women aged 20–44 years.

Conclusions

Based on the experimental results, this study provides a set of benchmarks for the formulae used in LDL-C tests when considering the factors of age and gender. Therefore, it is a valuable method for providing formula benchmarking.

Keywords:
Low-density lipoprotein cholesterol; Residual cholesterol; Friedewald formula; Triglyceride