Friedewald, Martin/Hopkins ve Sampson Denklemlerinin Düşük Yoğunluklu Lipoprotein Kolesterol Hesaplamasındaki Karşılaştırılması

Yıl 2025, Cilt: 35 Sayı: 4, 659 - 666, 29.08.2025

Esra Paydaş Hataysal , Beyza Saraçlıgil

https://doi.org/10.54005/geneltip.1670413

Öz

Özet
Giriş/Amaç: Düşük yoğunluklu lipoprotein kolesterol (LDL-K) ölçümünde referans yöntem olan ultrasestrifügasyon, klinik laboratuvarlarda pratik olmaması nedeniyle yerini direk testlere bırakmıştır. Ancak direk testlerin yüksek maliyeti ve katkısının az olması nedeniyle LDL-K tahmin denklemleri kullanılmaktadır. Bu çalışmada amacımız, trigliserid düzeyi 400 mg/dL'nin altında olduğunda Friedewald, Martin/Hopkins ve Sampson denklemlerinin tahmin performanslarını bir direkt ölçüm yöntemiyle karşılaştırmaktır.
Yöntemler: Çalışmaya, Abbott Architect c8000 ve c400 cihazları (Abbott Laboratories, Abbott Park, IL) ile analiz edilen toplam 8.632 lipid profili dahil edildi. LDL-K eşik değerleri olan 70 mg/dL ve 190 mg/dL’ye göre hastaları yanlış sınıflandıran durumlar klinik olarak anlamlı hata olarak kabul edildi.
Bulgular: Desirable Bias kriterlerini (±%5,4) karşılayan sonuç yüzdesi sırasıyla Friedewald, Martin/Hopkins ve Sampson denklemlerinde %52,5, %58,2 ve %56,2 idi. Toplam izin verilebilir hata sınırlarını (±%11,8) karşılayan sonuç yüzdesi sırasıyla %84, %89,1 ve %87,7 olarak bulundu. Friedewald, Martin/Hopkins ve Sampson denklemleri negatif orantılı bias gösterdi; medyan bias sırasıyla −%2,3, −%1,9 ve −%0,7 idi. Trigliserid düzeyinin 200–399 mg/dL arasında olduğu durumlarda, Friedewald denkleminin medyan yüzde biası −%8,2 olarak bulundu ve bu değer desirable bias kriterlerini aşmıştır. Klinik olarak anlamlı hata oranları Friedewald, Martin/Hopkins ve Sampson denklemleri için sırasıyla %6, %4,9 ve %5,5 olarak belirlendi.
Tartışma:Abbott platformu kullanılarak Türk popülasyonunda yapılan bu LDL-K tahmin denklemleri karşılaştırmasında, Martin/Hopkins ve Sampson denklemleri arasında yalnızca küçük farklar bulunmasına rağmen, her ikisi de Friedewald denklemine göre daha yüksek doğruluk göstermiştir. Sampson yöntemi sınırlı da olsa daha iyi sonuçlar verirken, Martin/Hopkins denklemi de klinik olarak geçerli bir alternatiftir.

Anahtar Kelimeler

Düşük Yoğunluklu Lipoprotein Kolesterol , Kardiyovasküler Hastalık , Friedewald Denklemi , Bias

Proje Numarası

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Comparison of the Friedewald, Martin/Hopkins, and Sampson Equations for Calculating Low-Density Lipoprotein Cholesterol

Öz

Abstract
Background/Aims: Ultracentrifugation, which is the reference method for low-density lipoprotein-cholesterol measurement, has been replaced by direct assays because it is not practical in standard clinical laboratories. However, due to the high cost and limited added value of direct assays, predictive equations are used. In this study, our aim was to compare the predictive performances of the Friedewald, Martin/Hopkins and Sampson equations to a direct assay when the triglyceride level is below 400 mg/dL
Methods: A total of 8,632 lipid profiles analyzed with Abbott Architect c8000 and c400 devices (Abbott Laboratories, Abbott Park, IL,) were included in the study. Those that misclassified patients based on low-density lipoprotein-cholesterol thresholds of 70 mg/dL and 190 mg/dL were identified as clinically relevant errors.
Results: The percentage of results meeting desirable bias specifications (±5.4%) was 52.5%, 58.2%, and 56.2% in the Friedewald, Martin/Hopkins, and Sampson equations, respectively. The percentage of results meeting the total allowable error specifications (±11.8%) was 84%, 89.1% and 87.7% in the Friedewald, Martin/Hopkins and Sampson equations, respectively. The Friedewald, Martin/Hopkins and Sampson equations showed negative proportional biases with a median bias of −2.3%, -1.9% and -0.7%, respectively. When triglyceride level was between 200–399 mg/dL, the median percentage bias was -8.2% for the Friedewald equation which exceeded the desirable bias criteria. The rates of clinically relevant errors for the Friedewald, Martin/Hopkins, and Sampson equations were 6%, 4.9%, and 5.5%, respectively.
Conclusions: Our comparative analysis of LDL-C estimation equations using the Abbott platform within the Turkish population reveals that while the Martin/Hopkins and Sampson equations exhibit only marginal differences in performance, both demonstrate superior accuracy relative to the Friedewald equation. Although the Martin/Hopkins yields marginally preferable outcomes, Sampson equation remains a clinically viable alternative.

Anahtar Kelimeler

Low-Density Lipoprotein Cholesterol , Cardiovascular Disease , Friedewald Equation , Bias

Etik Beyan

The study followed the guidelines set forth in the Declaration of Helsinki, and the procedures were approved by the Ethics Committee of Fenerbahçe University (no: 20.2025fbu, date:19.02.2025).

Destekleyen Kurum

none

Proje Numarası

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Teşekkür

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Kaynakça

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