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Friedewald and Martin-Hopkins formulae for estimating low-density lipoprotein cholesterol in a Malagasy population
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DOI：10.4102/ajlm.v15i1.3012.png)
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Abstract
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Background: Low-density lipoprotein cholesterol (LDL-C) estimation is commonly used in Madagascar due to cost-effectiveness. However, genetic variability and formula limitations may affect accuracy. Objective: To compare LDL-C estimated by the Friedewald and Martin-Hopkins formulae with directly measured LDL-C in a Malagasy population. Methods: LDL-C values estimated using both formulae were compared with direct LDL-C in 346 samples from patients >= 18 years analysed in a biochemistry laboratory. Samples were divided into four groups based on triglyceride levels: < 1.13 mmol/L; 1.13 mmol/L-1.69 mmol/L; 1.69 mmol/L-2.26 mmol/L; >= 2.26 mmol/L. Results: Both formulae showed a strong, statistically significant correlation with direct LDL-C (r = 0.89). Mean comparison revealed overestimation by both formulae, more pronounced with Friedewald (mean difference 0.15 mmol/L) than Martin-Hopkins (0.21 mmol/L). Differences increased with rising triglyceride levels. Both formulae demonstrated good agreement with direct measurement, acceptable biases and similar limits, but Friedewald had a lower overall percentage error. Conclusion: The Friedewald formula showed better correlation, higher concordance and lower mean difference than Martin-Hopkins. Both formulae showed limitations depending on triglyceride concentration. What this study adds: This study evaluates Friedewald and Martin-Hopkins LDL-C estimation against direct measurement in a Malagasy population, highlighting their validity in Africa and implications for clinical decisions in resource-limited settings.
Keywords:
low-density lipoprotein cholesterol
triglyceride
Friedewald formula
Martin-Hopkins formula
Madagascar
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