Used in MPhil thesis calculations and analysis [Population Variation for Risk Factors in Ischaemic Heart Disease, 1992].
Estimation of LDL-cholesterol (LDLc) using the Friedwald Formula. [Friedwald, W. T. et al. Estimation of the concentration of low density lipoprotein cholesterol without use of the preparative centrifuge. ClinChem. (1972), 18 (499-502].
Original Friedwald Formula (FF) = LDLc, mmol/L = TC – HDLc – (TG x 0.45). LDL-c, mg/dL = TC – HDLc – (TG x 0.20).
Estimation of total cholesterol (TC) = TC = VLDLc + LDLc + HDLc.
Lipid Classification – total lipids cholesterol (HDL + LDL) + triglycerides (VLDL). Measurements of these cholesterol fractions can be obtained by knowing two of them from the following formula:
LDL = TC – TG/5 – HDL (in mmols). [See : Graham, M. (1988). The Effects of Cholesterol. The Physician].
Also – LDLc = TC – HDLc – TG/2.19 (mmols). [See: Day, R. et al. (1989). Treatment for hypertriglyceridaemia – state of the art. Card in Pract. Feb].
Modification of the original FF. See: DeLong D. M. et al. (1986). A comparison of methods for the estimation of plasma low- and very low-density lipoprotein cholesterol. JAMA 256 (11). Nov.
The DeLong modification of FF. LDLc, mmol = TC – HDLc – (TG x 0.37). LDLc, mg/dL = TC – HDLc – (TG x 0.16).
They concluded that LDLc was better estimated using the following formula:
LDLc = TC – (LDLc + 0.16 x TG). mmols. Or: LDLc = TC – (HDLc + 0.37 x TG). mg/dL.
This proposed formula is more precise for plasmas or sera with a TG concentration within the normal range.
Thus the original FF = plasma TG in mgms/L is determined and an estimate of VLDLc in mgms/L is made by: dividing TG by 5 (i.e E-VLDLc = 0.20 TG), (0.46 in mmols). DeLong called estimated VLDLc – E-VLDLc.
Therefore – estimation of E-VLDLc = E-LDLc = TC – (HDLc + E-VLDLc) = TC – (HDLc + 0.20 X TG)
Modification of the original FF using an intercept: the linear regression coefficient for VLDLc on TG and the intercept.
See: Rao, A. et al. (1988). Calculation of low-density lipoprotein cholesterol with use of triglyceride/cholesterol ratios in lipoproteins compared with other calculation methods. Clinical Chemistry. 34 (12).
Therefore – LDLc mmol/L = TC – HDLc – (TG x 0.342) = 0.118. Also – LDLc mg’dl = TC – HDLc – (TG x 0.148) + 4.6.
Using an FF that varies with TG: FF was found to correlate significantly with TG. (FF = 0.47 – (0.022 x TG).
Therefore – LDL mmol = TC – HDLc – TG = [0.47 – (0.022 x TG)]. Thus – LDL mg’dl = TC – HDLc – TG = [0.022 – 0.00011 x TG)].
Rao, A. et al (1988).
To be continued
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