Comparison of existing methods of low-density lipoprotein cholesterol estimation in patients with type 2 diabetes mellitus

Introduction: Elevated low-density lipoprotein cholesterol (LDL-C) is an important risk factor for atherosclerotic cardiovascular disease (ASCVD). Direct LDL-C measurement not widely performed. routinely calculated using the Friedewald equation (FLDL), which inaccurate at high triglyceride (TG) or low levels. We aimed to compare this routine method with other estimation methods in patients type 2 diabetes mellitus (T2DM), who typically have elevated TG levels and ASCVD risk. Method: performed a retrospective cohort study on T2DM from multi-institutional registry Singapore 2013 2020. values estimated by equations: FLDL, Martin/Hopkins (MLDL) Sampson (SLDL) were compared measures of agreement correlation. Subgroup analysis comparing directly measured (DLDL) was conducted single institution. Estimated considered discordant if <1.8mmol/L index ≥1.8mmol/L comparator. Results: A total 154,877 included final analysis, 11,475 subgroup analysis. All 3 equations demonstrated strong overall correlation goodness-of-fit. Discordance 4.21% FLDL-SLDL 6.55% FLDL-MLDL. In discordance 21.57% DLDL-FLDL, 17.31% DLDL-SLDL 14.44% DLDL-MLDL. rates increased >4.5mmol/L. Conclusion: correlations between newer estimation, DLDL. At higher concentrations, no well. The had least DLDL, may minimise misclassification FLDL SLDL.