Assessing the Validity of Nine Different Formulae for LDL-C Estimation in a Tertiary Care Centre, Hyderabad, India

Introduction: Conventionally, Friedewald’s formula has been used to calculate Low Density Lipoprotein- Cholesterol (LDL-C) due to its simplicity and convenience although it has limitations. Many researchers have proposed different formulae to increase the accuracy of calculated LDL-C, but none of those have concluded about a single best formula owing to differences in selected study populations. As LDL-C measurement is of utmost importance for assessing the cardiovascular risk according to National Cholesterol Education Programme’s (NCEP) Adult Treatment Panel III (ATP III), a search for a better formula to improve accuracy of cardiovascular disease (CVD) risk prediction is essential. Aim: To assess the validity of calculated LDL-C by nine formulae and compare them to values obtained by the direct method. Materials and Methods: A total of 324 participants were assessed retrospectively for serum lipid profile by standard methods from December 2020 to February 2021 at Employee State Insurance Corporation Medical College and Hospital, Sanathnagar, Hyderabad, Telangana, India. LDL-C was calculated using nine different formulae (Ahmadi, Anand, Chen, de Cordova, Friedewald, Hattori, Martin-Hopkins, Puavillai and Vujovic) and correlated with direct LDL-C. For further analysis, subjects were divided into five groups based on the Triglyceride levels (TG) viz; group 1 (TG <100 mg/dL), group 2 (TG: 100-150 mg/dL), group 3 (TG: 151-200 mg/dL), group 4 (TG: 201-400 mg/dL), group 5 (TG >400 mg/dL). Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 23.0. Results: Total of 324 lipid profile reports were analysed and calculated LDL-C by nine formulas were compared. At TG levels 400 mg/dL, Puavillai had better accuracy. But, none of the formulae showed strong correlation with Direct LDL-C at TG >400 mg/dL. ROC curves also showed that Puavillai performed better among all formulae, at all TG levels. Conclusion: Among the nine equations, Puavillai and Martin-Hopkins showed highest accuracy and better performance than others in the present study population. Martin-Hopkins can be used at TG levels of 100-200 mg/dL while Puavillai can be used at lower and higher TG levels in this demographic population for estimating LDL-C

Association of fructosamine, glycated albumin and hba1c in prediabetes, diabetic and associated complications

Background: The efficient diagnosis and accurate monitoring of diabetic patients are cornerstones for reducing the risk of diabetic complications. Aims: Aim of the study is to assess level of Glycated hemoglobin, serum fructosamine, Glycated albumin in Prediabetes, type-2 Diabetic patients with and with out microvascular complications and to find out their correlation with diabetes complications. Materials and methods: This is a Case-control study in200 subjects will be involved in this study and they will be divided into 4 groups. The controls and subjects (cases) were age and gender matched. Samples collected from patients after obtaining Informed written Consent. Results: .&nbsp; Differences between these groups for serum fructosamine, glycated albumin were statistically significant. Glycated albumin showed excellent correlation with fructosamine across groups (p ≤ 0.0003 in all groups) and correlation coefficient r was &gt;0.9 in groups 2 and 3. Serum fructosamine and glycated albumin correlated well with FBS, PP2BS, HbA1C in groups 2, 3 and 4. Irrespective of the groups, serum glycated albumin showed excellent correlation with serum fructosamine.